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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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Isolation notes and letters for Covid-19 related absence from the workplace

Please be aware that as people are returning to work there may be an increase in patients contacting the practices with concerns and anxiety about their return and requesting medical certificates. Patients need to be encouraged to discuss this with their employer and not medicalise what is an understandably anxiety provoking situation. Practices should try and avoid issuing medical certificates for this reason. ACAS has produced guidance for employees on how to address these concerns.

  1. Those who are self-isolating because they are symptomatic or have a symptomatic household contact
    Patients who are self-isolating because they or someone in their household has Covid-19 symptoms can get their own certificate using the online NHS 111 isolation note tool. We recommend that you add this link to your practice website. Patients do not need to speak to a GP unless their symptoms are worsening and they need clinical advice. If a patient does not have an email address, they can have the note sent to a trusted family member or friend, or directly to their employer. The service can also be used to generate an isolation note on behalf of someone else.
  2. Moderate risk group (clinically vulnerable)
    Patients in this group roughly equate to those eligible for the annual flu jab. Current advice is that they should continue to go to work if they can’t work from home. Please direct patients to download and use the Londonwide LMCs’ template letter as these patients will not be eligible for a MED3, which is for certifying due to illness. If they become unwell, point 1 applies.
  3. People at high risk (clinically extremely vulnerable)
    This group should receive a letter from the government (or their GP/specialist if not identified through the central process) confirming they are in the high risk category which can be used for the purposes of certification off work. The CMO has provided a specific list of qualifying conditions that would be classified as defining a patient as clinically extremely vulnerable. This means they should self-isolate within the home where possible and work from home if possible. If this is not possible they should discuss with their employer to make suitable arrangements in the workplace unless their letter has advised them to shield. Further guidance on isolation, stringent social distancing and shielding is available here. Details of borough based local authority telephone helplines for vulnerable and shielding residents can be found here
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