Guidance Note for Patients

Returning to work, “shielding” from COVID-19 infection and isolating with symptoms.

Sefton Local Medical Committee logo

Dear Patient

As the COVID-19 Lockdown is relaxed and business and organisations begin to resume normal operations, we are aware that some patients may be requested by their employer provide corroboration from their GP that they are clinically vulnerable from COVID-19 infection or presently manifesting symptoms of COVID-19 and should not attend work.

GPs are unable to provide individual risk assessments or letters/fit notes, to confirm vulnerability or COVID-19 symptoms.

Sefton Local Medical Committee has prepared this notice on behalf of your GP practice, to guide you and your employer on the official verification and corroboration which may already cover your circumstances in connection with a return to work at this time.

Sefton Local Medical Committee is a statutory body that advises and supports all GPs and practice teams in the Borough of Sefton.

Highly Vulnerable and Shielding persons:

  1. People who are considered extremely clinically vulnerable and shielding should continue to shield and should not be expected to attend work (see Appendix 1). If you have already received a letter from the NHS Executive, a Hospital Department or your GP advising you that you are highly vulnerable this is sufficient evidence to confirm that you should isolate until advised that it is no longer necessary to do so.
  2. Clinically vulnerable (but not highly clinically vulnerable) people are those considered to be at a higher risk of severe illness from coronavirus (see Appendix 2). If you have received a letter from your GP or hospital Department advising you should be shielding, this is sufficient evidence that you should not be expected to attend work until the clinical advice about shielding changes.
  3. People who live in a household with someone who is extremely clinically vulnerable (see Appendix 1) and shielding, should ensure that they do not expose this person to COVID-19 infection. Stringent social distancing should be maintained and if necessary, isolation to protect the person who is highly vulnerable. A copy of the letter received by the vulnerable person which confirms your common address is sufficient to show that stringent social distancing measure are necessary.
  4. People who live with someone who is clinically vulnerable (but not highly clinically vulnerable) as defined in the social distancing guidance (see Appendix 2) should be able to attend work if strict social distancing can be adhered to. At work your employer should have completed a risk assessment relating to the risk of infection to staffs and will have put in place social distancing measure to minimise the likelihood of COVID-19 passing between colleagues. Your employer is advised to share the risk assessment with staff.
  5. You and your employer may find it helpful to note the guidance issued by the Health and Safety at Work Executive on risk assessment and guidance with respect to resuming work operations:
    GOV.UK guidance: working safely during Coronavirus (COVID-19)
  6. If you have or develop the symptoms of COVID-19 (see Appendix 3) the current official Government/NHS guidance is that you should isolate for 14 days and you should also contact NHS 111 which will provide a letter confirming your symptoms. The official guidance on isolation if you have the symptoms of COVID-19 are sufficient confirmation of the need to refrain from work for the isolation period, Statutory sick pay arrangements have bee adjusted to provide statutory sick pay from the day of manifesting COVID-19 symptoms and having to cease work because of this. Owing to these arrangements GP fit notes are not required and GPs cannot issue Fit Notes to verify COVID-19 symptoms

We trust this guidance will be helpful to you and we recommend that you show it to your employer. We attach links below to the most recent government guidance on isolating for vulnerable/shielding persons during the COVID-19 pandemic. You can find advice concerning many aspects of work and returning to work from you trade union or the ACAS.

Sefton Local Medical Committee
12 Church St, Southport, PR9 0QT


Appendix 1

Who is ‘clinically extremely vulnerable’?

Clinically extremely vulnerable people include the following:

  1. Solid organ transplant recipients
  2. People with specific cancers:
    • people with cancer who are undergoing active chemotherapy.
    • people with lung cancer who are undergoing radical radiotherapy.
    • people with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment.
    • people having immunotherapy or other continuing antibody treatments for cancer.
    • people having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.
    • people who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.
  3. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD).
  4. People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
  5. People on immunosuppression therapies sufficient to significantly increase risk of infection.
  6. Women who are pregnant with significant heart disease, congenital or acquired

Appendix 2

Clinically vulnerable people

If you have any of the following health conditions, then you are clinically vulnerable, meaning you are at higher risk of severe illness from coronavirus. You should take particular care to minimise contact with others outside your household.

Clinically vulnerable people are those who are:

  1. aged 70 or older (regardless of medical conditions)
  2. under 70 with an underlying health condition listed below (that is, anyone instructed to get a flu jab as an adult each year on medical grounds):
  3. Suffer from:
    • chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic obstructive pulmonary disease (COPD), emphysema or bronchitis.
    • chronic heart disease, such as heart failure.
    • chronic kidney disease.
    • chronic liver disease, such as hepatitis.
    • chronic neurological conditions, such as Parkinson’s disease, motor neurone disease, multiple sclerosis (MS), or cerebral palsy.
    • diabetes.
    • a weakened immune system as the result of conditions such as HIV and AIDS, or
    • medicines such as steroid tablets.
    • being seriously overweight (a body mass index (BMI) of 40 or above)
    • pregnant women.

Appendix 3

The symptoms associated with COVID-19 are:

  • high temperature
  • new, continuous cough
  • loss or change to your sense of smell or taste

Useful resources

When to self-isolate and what to do - Coronavirus (COVID-19) - NHS

How to avoid spreading coronavirus to people you live with - Coronavirus (COVID-19) - NHS

Download this document as a PDF file

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