Support for specific groups
Shielding and clinically at risk
This guidance applies to those who are at the highest clinical risk from coronavirus (known as the shielding category). Advice to those who are shielding is available online at www.mygov.scot/shielding. This has been updated in the context of the new variants of concern.
The approach to shielding is based on the following principles:
- advice must be proportionate to the level of infections in the local community;
- it should be set at a level which optimises the benefits of protection and minimises health, social and economic harms;
- it should be practical, empower people to make decisions which are right for them, and be culturally appropriate and tailored to ensure reach and accessibility.
Staff who are on the shielding list are advised that if they cannot work from home, then they should not go into work as long as the area they live or work in is under lockdown. The Chief Medical Officer’s advice issued on 5 January for people on the shielding list living or working in areas under lockdown is that if your employer cannot arrange for you to work from home, then you should not attend work. This advice remains, regardless of whether you have had 1 or 2 doses of the vaccine. We will update this guidance if this advice changes as we learn more about the impact of the vaccine.
Children on the shielding list have been advised by the Chief Medical Officer not to attend regulated childcare services such as school age childcare settings in person in level 4 areas or during lockdown. However, parents can consult with their child’s secondary care (hospital) clinical team who may advise that an individualised risk assessment could be undertaken with the setting and arrangements put in place which may allow their child to attend.
While restrictions across mainland Scotland increased protection for those who are at most clinical risk, we have considered what additional measures we can advise to reduce the increased risk of transmission of the new variants of coronavirus and further reduce opportunities for infection.
Please encourage staff and parents of children on the shielding list to consider joining the free text messaging service for people at highest risk from coronavirus. To join, they can send a text from their mobile phone with their Community Health Index (CHI) number to 07860 064525. They can also get information from the free National Assistance Helpline on 0800 111 4000.
There are levels of advice to protect people with the highest clinical risk (shielding), setting out clearly how advice will change depending on the rates of infection in local areas. As the levels in a local area change, the protection advice for people on the shielding list in that area may change. People at highest risk should still follow the advice for the general public as a minimum but take note of the expectations about workplace risks assessments for those who are shielding at each protection level.
The majority of workplaces can be made safe. Workplace risk assessments should take account of age, sex, ethnicity, body mass index (BMI) as well as clinical conditions and recommend protective measures. The outcome of those risk assessments may include implementation of specific mitigations in the workplace, undertaking different duties, working remotely, including from home, or being advised not to attend work, in line with medical advice to do so. Local authorities should ensure that clinical advice is taken fully into account when agreeing appropriate mitigations with employees and trade unions.
To support individualised risk assessment in the workplace, shielding advice also contains links to the Coronavirus (COVID-19): guidance on individual risk assessment for the workplace.
Information in relation to pupils’ attendance and absence is published by Scottish Government Education Analytical Services. This may assist individuals’ and employers’ understanding of case numbers in relation to school age childcare settings, which may be helpful as part of risk assessment within the individual setting.
Parents/carers may wish to have a discussion with their child’s healthcare team if they are unsure or have queries about returning to or attending school because of their own health condition.
Support for those who have underlying health conditions
Clinically vulnerable staff (including those who have underlying health conditions, but who would not be on the shielding list) can continue to work in settings, subject to a dynamic risk assessment confirming it is safe to do so. Arrangements should be made to enable appropriate physical distancing. If they have to spend time within 2 metres of others, settings must carefully assess and agree with them whether this involves an acceptable level of risk.
Where any concerns do exist, guidance for people with underlying health conditions has been prepared and will continue to be updated. Staff who have underlying health conditions will wish to be aware of this advice in order to inform discussions with their employer, trade union and/or healthcare team.
Considerations related to pregnancy
In line with the UK Government Coronavirus (COVID-19): advice for pregnant employees, which applies in Scotland, pregnant staff of any gestation should only continue working if a risk assessment advises that it is safe to do so.
Schools and local authorities should follow the Royal College of Obstetricians and Gynaecologists advice to try and keep the risk of exposure as low as is practically possible to pregnant employees, particularly in the third trimester. Normal pregnancy risk assessments should also be undertaken, and appropriate attention paid to mental health and wellbeing.
Coronavirus (COVID19): Individual Risk Assessment Guidance
On 27 July 2020 Scottish Government published COVID-19 Occupational Risk Assessment Guidance. This guidance includes an easy to use, individual risk assessment tool that takes into account ethnicity, age, gender, BMI and health conditions to give an overall COVID-19 risk age.
Staff and employers in all sectors now use this guidance to determine whether or not, the workplace is safe and it is safe for the individual to be at work. This guidance is relevant to staff who have an underlying health condition, or are anxious about risks in the workplace. The guidance is based on the latest clinical and scientific advice on COVID-19 and is updated on a regular basis.
The clarity this tool brings has been widely welcomed, as we now know that certain minority ethnic groups are more vulnerable to COVID-19 and that simply viewing medical conditions in isolation, does not accurately predict an individual’s vulnerability.
The most important part of the process is the conversation that takes places between a manager and a member of staff. It is essential that the outcome from these conversations is agreed by both parties. The conversation should take into consideration, workplace risks, and the control measures that can be put into place, to agree a course of action regarding work duties. The guidance also signposts to further medical advice and support for those with complex vulnerabilities.
Support for children with Additional Support Needs
Every child will have different levels of required support. It will be important as part of the risk assessments carried out to consider the individual needs of a child or young person. Where there is a need to work in close proximity with adults and children people the appropriate safety measures should be put in place based on that risk assessment. Guidance on supporting children and young people with additional support needs is published by the Scottish Government.
Providers should have individual risk assessment processes in place to support individuals in the groups above. As well as wider planning around the child in line with GIRFEC principles, they should have reference to Scottish Government guidance on individual risk assessment for staff in the workplace.