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Living Guide

This living document is produced by the GP medical directors of Londonwide LMCs in collaboration with clinical colleagues within the NHS system in London to guide London’s GP practices to best help our patients.
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Information regarding shielding, self-isolation and social distancing

A further Government update was issued for the clinically extremely vulnerable, in areas placed into new
Tier 4 restrictions, from 20 December 2020. We are currently in a national lockdown so this guidance
applies to all London residents. This group is strongly advised to stay at home, unless for exercise or
medical appointments and not to attend work.

The updated guidance includes:

  • Socialising: Stay at home. You must not leave your home except to go outdoors to exercise or attend medical appointments.
  • Work: If people cannot work from home, they should not attend work. They may be eligible for SSP (using the SPL letter), ESA, Universal Credit or the Coronavirus Job Retention Scheme during this period. People in the same household who are not shielding can still attend work.
  • School: Colleges, primary and secondary schools will remain open only for vulnerable children and the children of critical workers. All other children will learn remotely until February half term.
  • Going outside: Stay at home. Avoid all non-essential travel – except to hospital and GP appointments if needed. Shielded patients are strongly advised not to go to any shops or pharmacies.

Government support is available for those who need it, while remaining at home, this includes access to food and medicines and signposting to local support. NHS volunteers can also help through phone calls and transport to and from medical appointments.

The clinically extremely vulnerable group includes those whose immune systems may be suppressed, those with specific cancers or severe respiratory conditions. The group list is regularly updated and people on the list will receive a specific identifying letter.

Those with more general underlying health conditions, or people aged 70 or over, may still be more
vulnerable to Covid-19 and should also stay at home as much as possible, follow the rules and minimise contact with others.

Letters were sent out by post in the week beginning 21 December 2020, to all those affected by the new
Tier 4 shielding rules. Anyone in Tier 4 areas who received a shielding letter in November and whose
condition is unchanged should follow the advice immediately. Letters will also be issued by email, to those who have registered an email address with their GP practice.

Details of borough based local authority telephone helplines for vulnerable and shielding residents can be found here.

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