Vulnerable staff 

The NHS have published information about those who are clinically vulnerable to COVID-19 and need to be stringent in following social distancing guidelines. There is also evidence that Black, Asian and minority ethnic (BAME) communities are disproportionately affected by COVID-19.

For vulnerable staff in these categories, the NHS should support staff to stay well and at work. NHS organisations should make adjustments to enable this wherever possible. Adjustments may include working remotely or moving to a lower-risk area.

Risk assessment is key to keeping staff safe. Risk assessment guidance for vulnerable staff can be found here and RCM wrap around guidance here. The Scottish government has published occupational health risk assessment guidance which can be found here. The development of local policies for carrying out risk assessments should be done in consultation with trade unions and Health and Safety representatives must be consulted on any workplace and workforce risk assessments. If you have concerns you should be able to ask for an individual risk assessment or risk assessment review if your circumstances change. Where there is a disagreement between line managers and occupational health or the person’s GP/consultant/midwife, clinical advice must always be followed. The NHS trade unions have developed principles on health and safety risk assessments and vulnerable workers which can be found here.  Joint NHS trade union principles on pregnancy and COVID-19 can also be found here.


If the outcome of a risk assessment includes being redeployed for a period of time staff should not suffer discrimination (direct or indirect) or additional disadvantage as a result of being temporarily redeployed through the COVID-19 risk reduction process. This should include pay protection to ensure staff do not suffer financial detriment, fears around loss of pay can act as a real barrier to participation in the risk assessment process. NHS Staff Council FAQs on pay protection can be found here


Clinically extremely vulnerable staff

Government advice for clinically extremely vulnerable staff has been updated to reflect the new national lockdown in England. The guidance can be found here, formal shielding advice has been reintroduced. Employers should ensure that all clinically extremely vulnerable staff are able to stringently following any active government guidance. If you are extremely clinically vulnerable, you are advised to continue to follow the most recent advice on shielding, even if you have had one or both doses of the vaccine.

There is clear advice on NHS Employers website for staff who have been advised to ‘shield’, including on pay which can be found here. If you are shielding and unable to work from home your employer should follow the advice for self-isolating and you should receive full pay through the provision of COVID-19 special leave.

NHS Employers guidance can be found here (terms and conditions during COVID-19 specific information here for Scotland, Wales and Northern Ireland).

The RCM has produced guidance on health and safety, PPE and your rights at work which can be found here.

Risk assessment is an important tool, however it is important to take into account wider organisational decisions which may impact on staff. An equality impact assessment (EqIA) is  vital to ensure new policies and practices are fair and don’t have unintended consequences for some groups. An EqIA must be carried out ahead of the introduction of any new COVID-19-related practices and policies, with the results shared with local trade unions and continuous monitoring and evaluation done in partnership. Practical support to reduce stress and infection risk should be communicated to staff, for example employee assistance programmes, childcare and transport.

NHS staff must feel able to raise concerns without fear of detriment and those concerns should be listened to.

If someone in your household is required to shield, and you are concerned about being in work you should discuss this with your line manager initially to explore what adjustments could be made. If you have caring responsibilities for someone who is shielding an employer should make reasonable adjustments including considering home working and using maximum flexibilities to support you.

As we learn more and more about COVID-19 it is clear it does not affect everyone equally. There is emerging evidence that you may be more at risk
depending on your race. This guidance will help you apply existing legislation to the arising issues in the current crisis. 

If you or anyone in your household has any coronavirus symptoms you must follow government guidance to self-isolate.

You (including bank staff) should receive full pay (inclusive of any enhancements and overtime) whilst you are self-isolating, please see relevant FAQ here.

If you subsequently become sick with coronavirus your trust/Health Board should record this separately and your absence should not be counted for the purposes of any sickness absence triggers or sickness management policies. For Agenda for Change staff whose sick pay is usually calculated using only basic salary, for the duration of the pandemic they will be paid sick pay as though at work (if they are off sick with COVID-19).

Many of us will feel higher levels of stress and anxiety at the moment. It is more important than ever to remember to look out for each other at work, make sure our colleagues are staying hydrated for example. Your employer has a duty to protect your health and safety at work, proper rest breaks and keeping a healthy work/life balance are key to this. Don’t forget the RCM’s Caring for You Campaign which aims to improve the health, safety and wellbeing of our members at work across the UK, speak to your RCM Workplace Representatives for more information. RCM branches should consider how to ensure members who are shielding or self-isolating in activities are able to remain involved in the branch and reduce feelings of isolation. If you are at home your employer should ensure you still have access to the mental health support that is available to staff in your trust

There are practical steps that can be taken to look after your mental wellbeing as well such as getting plenty of fresh air, exercising, eating healthy balanced meals and drinking plenty of water.

You may also have other responsibilities (such as caring for children/family members) at home that are impacting on how you are feeling we would encourage line managers to consider flexible working requests and team-rostering to ensure midwives and MSWs can maintain a health work/life balance. The RCM’s flexible working guidance can be found here (behind member login)

Agenda for Change handbook Section 33: Balancing work and personal life

The INDIGO POPPY team have developed a brief training video for midwives and maternity support workers that aims to reduce the development of post traumatic stress disorder (PTSD) in healthcare workers during the current COVID19 crisis. This is part of the University of Liverpool's support for health care staff and students. The team also includes members of staff at University of Nottingham, Liverpool John Moores University and Countess of Chester  Trust.

The video provides an understanding of normal human responses to traumatic events and covers how to help yourself and others in prevention of longer term distress. It is 38 minutes long in total but can be viewed in two parts if needed.


The INDIGO POPPY team would be very grateful for any feedback to the video to help shape their support programme further.


Employers should ensure that staff have enough rest in order to maintain their own physical and mental wellbeing. Annual leave is extremely important for rest and recuperation, particularly during this time. Though some staff may be working differently at the moment including from home, you are still entitled to your annual leave allowance set out in your terms and conditions of service. For absences related to Covid-19 however annual leave should not be the first call. Staff should not be requested to take leave whilst they are shielding or self-isolating.
Agenda for Change Handbook, Section 13: Annual leave and general public holidays.

There may be times during these exceptional circumstances where pre-booked leave may need to be delayed, this should be discussed with the member of staff and all other avenues explored. Decisions to cancel leave must be very carefully considered as part of emergency preparedness planning and done in consultation with local staff-side unions. If you are asked to cancel pre-booked leave, your employer should give the appropriate statutory notice.

Where staff cannot use their full entitlement of annual leave because of the pandemic, employers should consider revising their local policies to exercise maximum flexibilities in relation to carrying over of leave to the next leave year. This should be done in consultation with local staff-sides.

The NHS Staff Council has published guidance on best practice management of annual leave. The document sets out supporting principles to help trade unions work in partnership with employers to review local annual leave policies in response to COVID-19. The document can be found here

The NHS Staff Council has developed FAQs on sickness absence management related to COVID-19 covering delayed operations and treatments, pre and post-op self-isolation and phased return to work. You can find the guidance here.