• All patients identified as at highest clinical risk who are shielding are asked to register with the government support website (https://www.gov.uk/coronavirus-extremely-vulnerable). This service offers three types of support:
  1. Essential grocery supplies – a free, standardised weekly parcel of food and household essentials, as well as priority delivery slots with supermarkets (currently only available to those who are registered with the supermarket in question)
  2. Medicines – arrangements to have medicines delivered to people’s homes by local community pharmacies and dispensing doctors
  3. Social contact and basic needs – eg emotional or social support such as people to talk to on the phone or via a computer.
• To receive support, people must be in receipt of a letter from the NHS or their GP/hospital clinician, advising them to follow shielding guidance due to their medical condition.
• Please note, there may be a short delay between people being identified as at highest clinical risk with a flag applied to their patient record and support arriving.
• If people receive a letter but do not register with the government support website, government call agents will contact them directly to confirm whether they need support and to help them register if appropriate.

• Management of the shielding programme, working across several government departments and in close collaboration with local authorities.
• Identification of people in the highest clinical risk group who need support; sharing that information with councils.
• Provision and delivery of weekly food boxes to those who are shielding who have asked for assistance via the government support website.

The NHS

• Identification of people at highest clinical risk according to agreed clinical criteria.
• Delivery of medicines to those in the highest clinical risk group via community pharmacies and dispensing doctors.
• Supporting ongoing healthcare needs

Local councils

• Other support including care needs or social contact should individuals require it. This is co-ordinated by councils working with local statutory, voluntary and community sectors, plus private partners.

Food and grocery deliveries

• Government has offered a ‘direct to doorstep’ weekly food parcel delivery service for all those at highest clinical risk who need support getting essential supplies. This service will continue for as long as it is needed to protect those who are shielding.
• Each parcel provides a seven-day supply of essential items for one person, including food items, toilet tissue and hand soap and/or shower gel.
• An A4 note is included in each package, explaining that if the recipient has any allergies and/or religious or cultural dietary requirements, they should contact their local council. The note also asks people to contact their council if they feel they need more than one package a week.
• Food parcels are delivered directly to a person’s doorstep by major food service suppliers.
• If there is no answer, the parcel will be left on the doorstep. Parcels will not be left at a communal entrance and if there is no alternative to this the attempted delivery will be recorded as ‘unable to access’.
• Delivery drivers will observe strict social distancing measures when delivering food parcels.
• Delivery drivers will report the outcome of individual deliveries. This information will be shared with local councils.

Supermarkets

• The Government Digital Service has provided supermarkets with the details of people who are shielding, and has requested food parcels. It is able to prioritise the highest clinical risk group for click and collect services and/or home delivery.
• To receive a priority supermarket slot, shielding individuals must register on the government support website once they receive their NHS letter, or use the automated telephone line. When signing up, they must request essential food supplies for their data to be passed on to supermarkets.

Medicine deliveries

• The NHS has put in place arrangements for individuals to have medicines delivered by local community pharmacies and dispensing doctors during the COVID-19 outbreak, if they have requested this help via the government support website.
• Medicines are being delivered by community pharmacies or dispensing doctors to eligible individuals who, due to their medical condition, should not present at the pharmacy or the dispensing doctor dispensary, and do not have anyone they can ask to collect the medicine and deliver it to their door.
• This home delivery service will continue until the COVID-19 outbreak has subsided and government decides that community pharmacies and dispensing practices are no longer required to provide it.
• Where no family, friend, neighbour or carer is available, the pharmacy or dispensing doctor team must advise the person that a local volunteer may act on the pharmacy’s/dispensing doctor team’s behalf.

 Social contact and basic care

• Local councils are key to the effective delivery of this component of the support offer to people at highest clinical risk who are shielding and who have registered with the government website and requested assistance with social and basic care needs.
• Local councils should contact people who have indicated, via the government support website, call centre, direct contact with the council or another partner, that they require help to meet their basic needs (eg bathing, domestic chores) to ensure these are met. Councils will assess what help is required and how individuals can best be supported using existing resources or the voluntary and community sectors as appropriate.
• People who are shielding may experience anxiety, fear and loneliness during this period, especially those who have no network of nearby friends, family or neighbours.
• Data shared by the government support website with councils will indicate whether an individual has requested social contact during the period they are required to shield.
• It is for local councils to determine the best way to co-ordinate this support locally, working with voluntary and community sector partners.

• This government service provides access to food and medications, as well as help with social contact and basic needs while at home, if needed.
• Please contact your local council if you have an urgent need. Local councils are working with the voluntary sector and local communities to support residents during the response to COVID-19. You can find information about your local council here: https://www.gov.uk/find-local-council
• Your GP or other healthcare professional can also refer you for immediate help from an NHS volunteer. NHS Volunteer Responders can help you with:
  • check and chat – short-term telephone support to say hello if you are feeling lonely and isolated
  • community support – collecting shopping, medication or other essential supplies
  • patient transport – transport to take patients home who are medically fit for discharge.

• Health at home – this webpage lists available NHS services such as how to order repeat prescriptions online and get them delivered (https://www.nhs.uk/health-at-home/)

• Public Health England has provided guidance on looking after mental health and wellbeing during the COVID-19 pandemic: https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19

• Government has provided advice on employment and financial support: https://www.gov.uk/coronavirus

• Role of General Practice: as outlined in the letter about the second phase of NHS response to Covid-19, General practice will need to continue to stratify and proactively contact their high-risk patients with ongoing care needs, including those in the ‘shielding’ cohort to ensure they are accessing needed care and are receiving their medications.
• NHS Volunteer Responders: you can submit a live referral for an individual in need of support or an NHS service that requires volunteers, providing they meet the referring criteria, at https://www.goodsamapp.org/NHSreferral or on 0808 196 3382. Individuals can also self-refer for support by calling 0808 196 3646 between 8am and 8pm. Volunteers can provide:
  1. Check in and chat support – short-term telephone support to individuals who are at risk of loneliness as a consequence of self-isolation (note, this is not mental health advice);
  2. Community support – collection and delivery of shopping, medication or other essential supplies for someone who is self- isolating;
  3. Patient transport – transport to take patients home who are medically fit for discharge;
  4. NHS transport – delivery of medicines on behalf of the community pharmacy or dispensing doctor.
• Health at home – this webpage lists available NHS services such as how to order repeat prescriptions online and get them delivered (https://www.nhs.uk/health-at-home/).
• Public Health England has provided guidance on looking after mental health and wellbeing during the COVID-19 pandemic: https://www.gov.uk/government/publications/covid-19-guidance-for-the-public-on-mental-health-and-wellbeing/guidance-for-the-public-on-the-mental-health-and-wellbeing-aspects-of-coronavirus-covid-19
• Local councils are working with the voluntary sector and local communities to support residents during the response to COVID-19. You can signpost them to https://www.gov.uk/find-local-council, where they can locate their council and its website for information about locally available support.
• The government has provided advice on employment and financial support: https://www.gov.uk/coronavirus