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Living Guide

The Living Guide and linked documents are archived and are no longer being updated (last updated April 2021). Our monthly newsletter and website continue to provide updates on Covid-19 and many other issues.

Transport for London (TfL)

Since 15 June it has been mandatory for passengers over the age of 11 to wear face coverings on public transport in London, as well as in private hire vehicles. This has resulted in some patients approaching GP practices asking for doctor’s notes to exempt them from the requirement on health grounds, for example if they have asthma.

Print at home face coverings exemption card 

TfL have instructed passengers who are not required by law to wear face coverings to print out an exemption card and display it on clothing or a lanyard. It is also acceptable to display it on a mobile phone if you do not have a printer.

Passengers with neither a smartphone or printer should call TfL on 0343 222 1234 and arrange to have a card printed and sent to them.

TfL facemask exemptions

The requirement to wear a face covering on TfL’s public transport stations, platforms and services does not apply to:

  • Children under the age of 11.
  • Employees of, or persons providing agreed services to, TfL.
  • Police constables (including British Transport Police officers) acting in the course of their duty.
  • Members or employees of the emergency services responding to an emergency.

You also do not need to wear a face covering if you have a good reason not to, such as if:

  • You have a physical or mental illness or impairment, or a disability that means you cannot put on, wear or remove a face covering.
  • Putting on, wearing or removing a face covering would cause you severe distress.
  • You are travelling with, or providing assistance to, someone who relies on lip reading to communicate.
  • You are travelling to avoid injury or escape the risk of harm, and you do not have a face covering with you.
  • You need to remove it during your journey to avoid harm or injury or the risk of harm or injury to yourself or others.
  • You need to eat, drink, or take medication you can remove your face covering.
  • You are asked to remove your face covering by a police officer or other official, for example to check your railcard.

If a practice receives a request for an exemption letter, they should direct the patient to the exemption guidance and self-declaration certificates. Practices may wish to consider updating their website with this information and using a standard text such as the one below, in response to a patient requesting an exemption letter/certificate:

As a practice we are not able to provide any patient with an exemption certificate or letter. The risks of Covid-19 infection is still significant so please wear face coverings. Should you feel that you should be exempt from wearing a face covering please download an exemption card.

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