The information on this page is provided for information purposes only, and does not constitute legal advice. If legal advice is required you should contact a specialist legal firm.
This information applies to England only.
For information about Wales see our page on Employment and Covid-19 Wales
Last updated July 2020
- People with chronic kidney disease are at greater risk of severe illness from Covid-19 than the general population and a proportion of people with CKD are extremely vulnerable and are advised to shield.
- The shielding group should not return to the workplace before 31 July. After that date, extremely vulnerable people may return to the workplace only if it is not possible to work from home and only if the workplace can be made Covid-safe.
- It is extremely important that employers and employees communicate early about returning to work, a comprehensive risk assessment is conducted prior to a clinically and/or extremely vulnerable person returning to work and all appropriate action is taken to ensure the workplace is Covid-safe.
- If the workplace cannot be made Covid-safe and home working is not possible then government support is available, including extension of the furlough scheme for people furloughed for at least 3 weeks prior to June.
People with moderate to advanced (stage 3+) chronic kidney disease (CKD) are at greater risk from severe complications from coronavirus (Covid-19). This greater risk places them within the Clinically Vulnerable Group or the extremely Clinically Vulnerable Group, depending on the severity of their disease, the treatment they receive and other illnesses or conditions they have.
Government requires everyone to work from home if they can. However, some workplaces can now start to reopen. To support employers in their risk assessment responsibilities, this information covers risk level from Covid-19 for people with CKD and outlines Government guidance regarding how and if they can return safely to work.
Early and comprehensive discussions between employers and employees about how best to ensure safety at work guidance is followed will help to ensure that the employer is fulfilling its duty of care and that people with kidney disease can work safely.
From 1 August, advice to the clinically extremely vulnerable people will change, but advice to not return to work will remain in place until that date.
What vulnerability group are people with chronic kidney disease in?
Everyone with moderate to advanced chronic kidney disease (stage 3+) is at risk of severe illness if they catch Covid-19 and are therefore in either the ‘Clinically Vulnerable Group’ or the Clinically Extremely Vulnerable Group.
1) Clinically Extremely Vulnerable Group
A proportion of people with CKD are at particularly high risk from getting very severe illness if they catch Covid-19. They are in the Government’s Clinically Extremely Vulnerable Group.
The following people with CKD are in the Clinically Extremely Vulnerable Group:
- You have a transplant
- You are on dialysis
- If you over 70 and are on any form of immunosuppression or have been on one in the past
- Your kidney disease is caused by inflammation, a condition of your kidneys (sometimes called an autoimmune condition) AND you are in one or more of the following patient groups:
a) If you are currently receiving intravenous cyclophosphamide treatment or rituximab treatment or have done so within the last 6 months
b) If you are receiving cyclophosphamide treatment as tablets (oral treatment)
c) If you have received prednisolone at a dose equal to or above 20mg tablets every day for more than 4 weeks any time within the last 6 months
d) If you have received or currently are receiving more than 5mg every day of prednisolone for greater than 4 weeks taken with at least one other immunosuppressive type of medicine within the last 6 months.
e) If you suffer with nephrotic syndrome (sometimes described as protein leaky kidneys, usually due to minimal change disease, FSGS or membranous nephropathy) and are currently nephrotic (i.e. your protein leak is high/your ankles are swollen) or you have had more than one nephrotic (protein leaky) attack needing drug treatment during the last 6 months.
1.1 Clinically Extremely Vulnerable Group and returning to work
People in the Clinically Extremely Vulnerable Group are advised to shield. Shielding is a voluntary action that requires the individual to stay in their house or garden, except for exercising for a limited amount of time, with no visitors (except from a nurse, support or care worker). The full guidance can be viewed in Guidance on shielding and protecting extremely vulnerable persons from Covid-19
People who are shielding are advised to work from home and should not be going out to work until at least 31 July 2020.
Health and Safety Executive advice for employers is that “If a worker is shielding because they are clinically vulnerable you should not ask them to work outside their home. Help them to work from home, either in their current role or in an alternative role.”
1.2 How long should people shield for?
In England, people are currently advised to shield until the end of July 2020. More information is in Government guidance.
1.3 Family/household members of clinically extremely vulnerable people
A household member going out to work may increase the risk of a shielding person becoming infected with Covid-19. While household members are not advised to shield, it is important that employers talk to their workers and try to agree the best way to protect the shielded person. This may include working from home or changing roles, particularly for those working in public facing roles.
The Government’s “Working safely during Covid-19” guidance for specific industries all ask employers to pay particular attention to those who live with someone shielding in their household and advice on this is available on the Health and Safety Executive website.
The HSE state that employers should explain what will be done to protect workers living with someone in the shielding group, for example doing tasks where stringent social distancing guidelines can be followed.
1.4 Changes to the shielding group from 1 August 2020
The Government announced on 22 June that from 1 August 2020 people in the clinically extremely vulnerable group are no longer advised to shield themselves. From that date they should very carefully follow social distancing guidelines. They will remain at very high risk from severe complications if they become infected with Covid-19, but, because infection rates in the community are expected to reduce by then, this group have less risk of becoming infected.
The Government guidance states that, from 1 August, clinically extremely vulnerable people should continue to work from home if they can. But if they are unable to work from home but can work on site, they can do so, provided the business is COVID-safe.
All employers have been asked to work with the government to ease the transition back to a more normal way of life for their clinically extremely vulnerable employees. Employers and employees should start having conversations about safely returning to work, if working from home is not possible, as early as possible before the guidance is changed on 1 August. If employers cannot provide a safe working environment, they will still be able to access a range of government support: this includes the Coronavirus Job Retention (furloughing) Scheme for employees who have previously been furloughed for a full three-week period prior to 30 June and the Self-Employed Income Support Scheme.
The Health and Safety Executive have information on their website about shielding workers returning after 31 July: “As an employer, you have a legal duty to protect workers from harm. You should make sure you consider the risk to workers who are particularly vulnerable to coronavirus and put controls in place to reduce that risk.
You should talk to shielded workers about their working arrangements and take every possible step to enable your workers to work from home […]
When shielding is paused, where it is not possible for workers to work from home, you must regularly review your risk assessment, and do everything ‘reasonably practicable’ to protect those workers from harm.
If workers are in the shielded categories, explain what will be done to protect them, for example doing tasks where stringent social distancing guidelines can be followed.
This also applies to workers living with someone in the shielded group.”
2) Clinically Vulnerable Group
Chronic kidney disease is in the Government’s list of conditions which make people clinically vulnerable to Covid-19. People with CKD are in the Clinically Vulnerable Group,
unless the severity and type of their condition or treatment level places them within the Clinically Extremely Group (see above).
People in the Clinically Vulnerable Group are at higher risk of getting severe illness from Covid-19. Because of this, Government guidance states that individuals in the Clinically Vulnerable Group should be particularly stringent in following social distancing guidance.
2.1 Clinically vulnerable people and returning to work
People who are clinically vulnerable to Covid-19 are advised to carefully follow social distancing guidance. This means that they may return to the workplace if they cannot work from home but employers must be especially careful and take extra steps for anyone in their workforce who is in a vulnerable group.
Covid-19 secure guidelines state that people who are clinically vulnerable should be helped to work from home either in their current role or in an alternative role. If they cannot work from home then they should be offered the option of the safest available on-site roles, which enable them to stay 2m away from others. If they have to spend time within 2m of others, employers should carefully assess whether this involves an acceptable level of risk.
Guidance to support employers
- Specific guidance on how to ensure a workplace is following ‘Covid-19 secure guidelines’ is available for different workplaces to help an employer in its risk assessment responsibilities.8
- The Health and Safety Executive have provided practical information on how to make work and the workplace safe.
- The HSE have produced an example risk assessment to show what to include in a Covid-19 risk assessment, including for vulnerable employees.
Can a clinically vulnerable or extremely clinically vulnerable employee be dismissed or disciplined if they refuse to work because they feel they are at risk from Covid-19 in the workplace?
It is hoped that any concerns relating to health and safety of clinically vulnerable and extremely vulnerable employees can be dealt with through timely discussions between staff and their employers.
Employers have a legal duty to protect workers’ health, safety and welfare. Carefully following all guidance on protecting workers at risk of severe illness from Covid-19 is an important way of demonstrating how they are fulfilling this duty.
The Employment Rights Act 1996 protects employees from dismissal for absence from work, where that absence was due to a reasonable belief that attending work would put them in serious and imminent danger (and they could not reasonably have been expected to avert that danger). Although whether there is a serious and imminent danger would depend on a range of factors, such as the infection levels at that time, an employee who falls in the clinically vulnerable or extremely vulnerable group are more likely to be at serious and imminent danger if appropriate measures are not put in place.
It is also important to note that employment law protects people who make a ‘protected disclosure’ relating to health and safety concerns from dismissal or detriment. A protected disclosure can include a worker raising concerns that their health and safety is being put at risk, or that the employer is breaching its legal obligations in respect of the health and safety of its workers. More information is available on the Government website.
Under the Equality Act 2010, employers have a duty to make reasonable adjustments for disabled employees. The ACAS website explains that an employee is protected by law against unfair treatment and dismissal, if it’s because of a health condition that’s considered a disability under the Equality Act. It could be unlawful discrimination on the grounds of disability if an employer either unreasonably tries to pressure someone to go to work or unreasonably disciplines someone for not going to work.
Sources of information
- The Health and Safety Executive have extensive information on their website regarding working safely during the Covid-19 outbreak and can also be contacted via their website or on 0300 790 6787 (Monday to Friday 8.30am to 5pm)
- ACAS (The Advisory, Conciliation and Arbitration Service) has advise for employees and employers about working safely during the Covid-19 outbreak and has advice about dealing with any workplace problems. They have a lot of information on their website or their helpline is available on 0300 123 1100 (8am – 6pm)