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“At Risk” patients Vs “Extremely Vulnerable” patients Posted on 15 Apr 2020

Oakfield Street Surgery

“At Risk” patients Vs “Extremely Vulnerable” patients and Bank Holiday Update


Firstly, can we take the opportunity to thank the continued support of our patients and our wonderful staff during these unprecedented and difficult times. 


We are experiencing a high volume of calls regarding the shielding letters.  Patients who are extremely vulnerable will require shielding letters.  These patients are not common.  The shielding letters advise people to stay at home for 12 weeks and contain a range of further information and advice, including how those who have no-one else to support them can get medication and other essential items such as food. The conditions qualifying for shielding letters are:

1.    Solid organ transplant recipients

2.    People with specific cancers

a.    People with cancer who are undergoing active chemotherapy or radical radiotherapy for lung cancer

b.    People with cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment

c.    People having immunotherapy or other continuing antibody treatments for cancer

d.    People having other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors.

e.    People who have had bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs.

3.    People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary disease (COPD)

4.    People with severe single organ disease (e.g. Liver, Cardio, Renal, Neurological)

5.    People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as Severe Combined Immunodeficiency (SCID), homozygous sickle cell disease)

6.    People on immunosuppression therapies sufficient to significantly increase risk of infection

7.    Pregnant women with significant heart disease, congenital or acquired

8.    Children (up to the age of 18) with significant heart disease, congenital or acquired


The criteria is quite strict but if you believe you fit into this criteria and have not received a letter then please contact the surgery.  If we agree that you meet the criteria; we may be able to issue a shielding letter.  Please note that we are not able to issue shielding letters to patients outside this criteria.


The extremely vulnerable patients mentioned above are different to the “at risk” group.  These patients will not receive a shielding letter but should practice as much social distancing as possible (


These are defined as:

·         aged 70 or older (regardless of medical conditions)

·         under 70 with an underlying health condition listed below (ie anyone instructed to get a flu jab as an adult each year on medical grounds):

·         chronic (long-term) respiratory diseases, such as asthmachronic obstructive pulmonary disease (COPD), emphysema or bronchitis

·         chronic heart disease, such as heart failure

·         chronic kidney disease

·         chronic liver disease, such as hepatitis

·         chronic neurological conditions, such as Parkinson’s diseasemotor neurone diseasemultiple sclerosis (MS), a learning disability or cerebral palsy

·         diabetes

·         problems with the spleen – for example, sickle cell disease or if you have had your spleen removed

·         a weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets or chemotherapy

·         being seriously overweight (a BMI of 40 or above)

·         those who are pregnant


We hope this helps the understanding of who should receive shielding letters and we ask for your patience and understanding when dealing with these queries as we refer back to the Government guidelines.


If you are in a shielding group and need further support please see the following useful links:

Shielding letters - advice, guidance and support for patients

Age Cymru Advice Number on 08000 223 444or email

Caerphilly Council 01443 811940

Social Services 0808 100 2500 


For furthe Coronavirus information please vist the Coronavirus tab on our website:


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