Further guidance for completing the individual clinical risk assessment

In managing occupational risks of COVID-19, employers must control exposure to the virus so far as is reasonably practicable, taking into account the possibility that some workers will be more vulnerable than others should they contract the disease.

The aim of this guidance is to provide advice to managers on how to identify and support staff who may have an increased risk, ensure additional control measures are implemented to reduce the risk as far as reasonably practicable and refer to Occupational Health for formal clinical assessment and advice if indicated.

As per Health and Safety Policy, it is essential that departmental and environmental risk assessments are conducted before any staff are allowed to return to work.

Once environmental risk has been reduced as far as is reasonably practicable, and staff groups that need to return to campus have been identified, an individual risk assessment can also be carried out to ensure that staff have no individual vulnerabilities that would place them at increased risk on their return.

Note: This does not have to be carried out for all staff. It is only required if a member of staff declares that they are still at risk due to vulnerabilities and where existing strategies have not removed the risk.

Risk assessment factors

There is evidence that people from Black, Asian and Minority ethnic (BAME) backgrounds are at higher risk from coronavirus (COVID-19). The relationship between ethnicity and health is complex and likely to be the result of a combination of factors.

Currently, there is no evidence to suggest that COVID-19 causes problems in pregnancy with the baby’s development or increases the risk of miscarriage. However, as a precaution, pregnant women have been included in the list of people at moderate risk, in particular, those who are 28 weeks and over as it is known that pregnant woman who contract significant respiratory infections in the third trimester are more likely to become seriously unwell. There is also evidence to suggest that pregnant women from BAME groups are at increased risk. There is not yet any information on the longer term effects of COVID-19 on unborn children.

The evidence also suggests that body mass index, age and gender can affect vulnerability. Only two gender options are provided as risk is determined by biological gender, or gender at birth. At present, there is no evidence available on whether or not transitioning has an impact on risk.

The individual risk assessment (Word, 35kb) will identify the different risk factors and increase the vulnerability score accordingly.

See the current guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19

Clinically Extremely Vulnerable (CEV) staff who have had shielding letters must adhere to government guidance in force at the time - staying at home during a national or local lockdown and only returning to campus once it is safe to do so. See the above guidelines for information on what to do if staff cannot work from home. If there is any uncertainty about CEV staff returning to work, the individual clinical vulnerability risk assessment (ICVRA) must be completed and a referral made to occupational health in order to determine if it is safe for them to return. 

Clinically Extremely Vulnerable (CEV)

People with the following conditions are automatically deemed clinically extremely vulnerable:

  • Solid organ transplant recipients.
  • People with cancers: undergoing active chemotherapy; lung cancer who are undergoing radical radiotherapy; cancers of the blood or bone marrow such as leukaemia, lymphoma or myeloma who are at any stage of treatment; immunotherapy or other continuing antibody treatments for cancer; other targeted cancer treatments which can affect the immune system, such as protein kinase inhibitors or PARP inhibitors; bone marrow or stem cell transplants in the last 6 months, or who are still taking immunosuppression drugs
  • People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD).
  • People with rare diseases and inborn errors of metabolism that significantly increase the risk of infections (such as Severe combined immunodeficiency (SCID), homozygous sickle cell).
  • People on immunosuppression therapies sufficient to significantly increase risk of infection.
  • People with problems with their spleen, for example splenectomy (having your spleen removed)
  • Adults with Down’s syndrome
  • Adults on dialysis or with chronic kidney disease (stage 5)
  • Women who are pregnant with significant heart disease, congenital or acquired
  • Others who may be classed as CEV, based on clinical judgement and an assessment of their needs. It has been identified that those who have multiple risk factors, may not meet the UK government shielding group definition but may still have a higher risk of developing severe COVID-19 infection. These members of staff should also continue to work from home where able to do so. If they are unable to work from home, and University local risk assessments indicate that the workplace is COVID-secure; staff are able to return to work (except in a national or local lockdown situation) however if there is any doubt about individual vulnerability, they should complete the ICVRA and be referred to Occupational Health if their combined risk factors indicate that they are at high risk.

For further information related to COVID-19 risk assessments please see the Health and Safety COVID-19 webpage (log-in required).

Those who may also be CEV but who do not fall into the above categories: 

Aged 70 or over (regardless of medical conditions)

Under 70 with an underlying health condition or combination of risk factors listed below:

  • 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 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
  • Poorly-controlled Diabetes
  • Being seriously overweight
  • BAME staff

See examples of how to fill in the individual clinical vulnerability assessment form (Word, 40kb)

In all cases, ensure workplace risk assessments have been carried out and social distancing can be maintained, workplace cleaning routine in place, provision of hand sanitisation stations and staggered use of shared facilities etc. Guidance on how make a referral to Occupational Health (log-in required)

Complete the referral form and submit to Occupational Health, along with a copy of the ICVRA and the outcome of the departmental risk assessment. Where staff may feel uncomfortable sharing this level of personal information with their manager, they should be encouraged to complete the details themselves, and just share the outcome with their line manager. The completed risk assessment should be returned to ochealth@le.ac.uk where it will be stored in confidence in their personal occupational health medical file.