From Wednesday 2 December, the government will replace the current national restrictions with a regionally differentiated approach, where different tiers of restrictions apply in different parts of the country. The government has provided specific guidance for clinically extremely vulnerable people at each local tier. The government is planning to communicate this updated guidance with all c.2.3m people on the Shielded Patient List (SPL) via letter. We expect this letter to be published on Saturday 28 November on the GOV.UK website. Letters may start arriving with patients from Saturday 28 November, and throughout all of next week (w/c 30 November). People for whom the NHS holds an email address will also receive an email copy of the letter on Monday 30 November. We know this communication may generate queries to general practices. Thank you for continuing to support those at highest risk from COVID-19 at this time.