15th July 2020

Cheshire LMC guidance note for patients requesting exemption letters from using face coverings

 The government guidance on exemptions suggests there is no requirement to produce evidence for exemption therefore it is sufficient for an individual to self-declare this. If your request relates to a transport matter then it will be a matter for the transport operator to determine. The responsibility for issuing exemptions is with the transport provider not your GP.

Similarly, practices are under no obligation to provide letters of support for anyone who does not fall under the list of exemptions but who might consider that they have another reason to be exempted.

Government advice on the use of face coverings can be found here:


Some people don’t have to wear a face covering who are deemed clinically extremely vulnerable including those with health, age or equality reasons. Some transport and other staff may not wear a face covering if it is not required for their job.

 We hope that this overview provides some reassurance for you on this issue and explains why your GP may not wish to provide any additional form of letter to support you.

 Yours sincerely

William Greenwood

LMC Chief Executive and Company Secretary

Appendix 1

 Who is ‘clinically extremely vulnerable’?

Clinically extremely vulnerable people include the following:

  1. Solid organ transplant recipients.
  1. 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 other targeted cancer treatments which can affect the immune system,
  • such as protein kinase inhibitors or PARP inhibitors.
  • people who have had bone marrow or stem cell transplants in the last 6 months, or
  • who are still taking immunosuppression drugs.
  1. People with severe respiratory conditions including all cystic fibrosis, severe asthma and severe chronic obstructive pulmonary (COPD).
  1. People with rare diseases that significantly increase the risk of infections (such as severe combined immunodeficiency (SCID), homozygous sickle cell).
  1. People on immunosuppression therapies sufficient to significantly increase risk of infection.
  1. Women who are pregnant with significant heart disease, congenital or acquired.