On the advice of The British Acupuncture Council I have to use my professional judgment as to whether to exclude clinically vulnerable clients from my practice based on their risk and vulnerability in relation to Covid-19 infection.  This is based on the categories of clinically vulnerable people and clinically extremely vulnerable people.  I'm sure you all know if you are one of these lists already!

Part of this process is to highlight to patients the nature of their increased risk status so that any decision they make to attend is based on informed consent.

The British Acupuncture Council is basing it's guidelines on those of the government.

Clinically vulnerable people

1.  Anyone aged 70 and older (regardless of medical conditions)
2. Anyone under 70 with an underlying health condition - that is, anyone instructed to get a flu jab as an adult each year on medical grounds - such as:

• • chronic (long-term) mild to moderate respiratory diseases, such as asthma, chronic 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 disease, motor neurone disease, multiple sclerosis (MS), a learning disability or cerebral palsy
  • diabetes
  • weakened immune system as the result of conditions such as HIV and AIDS, or medicines such as steroid tablets
  • being seriously overweight (a body mass index of 40 or above)
  • Pregnant women

Clinically extremely vulnerable people

The government issued this further advice detailing specific medical conditions that place someone at greatest risk of severe illness from Covid-19.  People who fall into this group will have been informed that they are clinically extremely vulnerable, and have been advised to "exercise shielding".

Shielding means that they have been told to:

• not leave their house
• not attend gatherings: including gatherings of friends and families in private spaces
• strictly avoid contact with someone who is displaying symptoms of Covid-19: these symptoms include high temperature and/or new and continuous cough.

People in this category are:

1.  solid organ transplant recipients
2. 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 targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors
   • 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 SCID, homozygous sickle cell)
   • People on immunosuppression therapies sufficient to significantly increase risk of infection
   • Women who are pregnant with significant heart disease, congenital or acquired.
   • Other people 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.