COVID-19: toolkit for GPs and GP practices

End of the shielding programme and closure of the Shielded Patient List (SPL)

Location: England Wales Scotland
Audience: GPs Practice managers
Updated: Tuesday 23 March 2021
Topics: COVID 19, GP practices

Throughout the pandemic, we have produced guidance for practices in England about arrangements for patients at high-risk of coronavirus.


Government guidance for practices and patients

The Government has now formally ended the shielding programme for the most vulnerable and that patients in England will no longer be advised to shield. This follows the pause of shielding since April 2021 and those previously shielding were advised to follow the same guidance as the public with extra precautions since 19 July.

The Shielded Patient List will also be closed, and NHS Digital will retain the capability to identify high-risk patients in the future. Relevant patients will be written to inform them of this change and that support still available.

Practice do not need to inform patients themselves, and any future changes to the COVID-19 risk status for patients will no longer be captured on the national list.

Please continue to refer to the latest government guidance on shielding.

  • The CMO sent a letter on 21 March 2020 asking practices to identify additional patients who may be known as being at highest clinical risk.
  • The Government eased the advisory guidance for clinically extremely vulnerable (CEV) people who were previously advised to shield at the end of July and that these patients were to continue with the care/treatment arrangements previously in place. 
  • Prior to the UK Government’s announcement of a three-tier (medium, high, very high) lockdown approach for England on 12 October, the BMA called for even stronger measures to reduce the spread of the COVID-19 infection and put forward a series of recommendations to help reduce the level of infection as well as supporting businesses and those who are in vulnerable groups.
  • On 13 October, it was announced that the most clinically vulnerable would receive updated guidance depending on the level of risk in their local area, in line with new local COVID alert levels framework, as coronavirus rates continued to rise.
  • Following the announcement of a second lockdown in England from 5 November, NHSEI wrote to practices to inform them of the new arrangements and although shielding was not being reintroduced as before, two additional groups were added (adults with stage 5 chronic kidney disease and adults with Down’s syndrome).
  • As of 2 December, CEV people were no longer advised to stay away from work or school, but recommended limiting the number of social interactions.
  • On 7 January 2021, a third national lockdown was introduced in England. The Government advised that clinically extremely vulnerable should take extra shielding measures to protect themselves, which ends on 31 March 2021.
  • The Government also extended the offer of a free 4-month supply of vitamin D supplements for all adults who are clinically extremely vulnerable to support general, ending on 21 February 2021.
  • Patients on the shielding list were sent a letter from government about what they should do. A copy of the letter is sufficient to give to an employer as evidence for statutory sick pay purposes should that be required. Patients in this situation should therefore not need a fit note issuing by the practice.