Clinically extremely vulnerable (Shielding) workers

Who needs to shield and what are the different tiers?

Covid-19 is particularly dangerous for people who have certain health conditions, due to the impact the virus has on the vital organs.  

During the pandemic, the UK Government defined some people as clinically extremely vulnerable (CEV)and requested them to shield at home from the period between late March and the end of July. 

You can find more advice on shielding and protecting vulnerable people on GOV.UK

Anyone with any of these conditions is considered to be Clinically Extremely Vulnerable, as of October 2020:  

  • solid organ transplant recipients 
  • 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 that 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 
  • people with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD) 
  • people with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell disease) 
  • people on immunosuppression therapies sufficient to significantly increase risk of infection 
  • women who are pregnant with significant heart disease, congenital or acquired 
  • other people who have also been classed as clinically extremely vulnerable, based on clinical judgement and an assessment of their needs. GPs and hospital clinicians have been provided with guidance to support these decisions 

Source: UK Government 

From 1st August, clinically extremely vulnerable workers can return to their workplace if it is COVID-secure but should carry on working from home wherever possible. 

Where it is not possible for workers to work from home, the employer must do everything ‘reasonably practicable’ (all that they can with the resources available to them) to protect those workers from harm. They must assess the risks from Covid, explain what measures will be implemented to protect them, and regularly review the risk assessment. They should consult competent occupational health professionals in performing the risk assessment, to make certain it accurately reflects the impact of the work on the workers’ condition. 

One tool to assist with the risk assessment process is the Covid-19 medical risk assessment tool developed by the Association of Local Authority Medical Advisors – see https://alama.org.uk/covid-19-medical-risk-assessment/ 

As of October 2020, ‘Shielding’ for Clinically Extremely Vulnerable people is paused in England, Northern Ireland, Scotland and Wales. Even with the three-tier system of restrictions announced by the Prime Minister on 12th October, there is no plan to reintroduce shielding.  

The UK Government say that this is because other measures – the Rule of Six; Social Distancing; face coverings; hygiene and handwashing etc – have reduced the overall risk of getting Covid.  

There are still specific actions that CEV workers should take for each tier. These are: 

Medium alert level: (Tier One)

  • Strictly observe social distancing 

  • Meet others outside where possible 

  • Limit unnecessary journeys on public transport 

  • Work from home where possible 

  • People can still go to work and children should still attend school. 

  • Rule of six applies 

High alert level: (Tier Two)

  • Reduce the number of different people you meet outside 

  • Avoid travel except for essential journeys 

  • Work from home where possible 

  • Reduce the number of shopping trips made or go at quieter times of the day 

  • Going to work - in Covid-secure workplaces - permitted if they cannot work from home 

  • Children should still attend school 

  • Restrictions on not meeting other households indoors, unless part of a support bubble apply as does the rule meet in groups of no more than six outdoors 

Very high alert level: (Tier Three)

  • Work from home 

  • Stay at home as much as possible 

  • Avoid all but essential travel 

  • Reduce shopping trips, and if possible use online delivery or ask people in your household, support bubble or volunteers to collect food and medicines 

  • People in these areas are encouraged to still go outside for exercise, and can still go to school and to work if they cannot work from home 

  • Additional support should be available from local authorities 


The UK Government has made it clear that shielding advice will not automatically be triggered by an area going into tier three, but it may be reintroduced in the future in hotspot areas in exceptional circumstances. Where this is the case, GMB will communicate this through our social media channels, and directly via Regional Organisers.  

Join more than 600,000 people and become a GMB member today
Join Us!