Obese people who are in their 50s may be asked to shield under local lockdowns, with a "blanket approach" to shielding replaced by more individualised advice, The Telegraph understands.
During the first wave of the pandemic, roughly 2.2 million people in England deemed "clinically extremely vulnerable" were asked to shield at home for months.
While some clinical criteria – such as undergoing particular treatments for cancer – is likely remain part of centralised guidance, GPs will be expected to make their own assessment of the risks facing their patients.
It means an obese smoker in their 50s with a history of medical problems might be advised to stay at home, while someone with a lower body mass index, suffering from other health problems, might not be issued with that advice.
Health officials stressed that no final decisions have been made on restarting the shielding programme. However, Government sources said GPs would be asked to look far more closely at the specific individual circumstances of a patient rather than to issue all those with a particular disease the same advice.
Dr Jenny Harries, the deputy chief medical officer, has been working with health officials on algorithms to assess risks for some months.
On Friday evening, GPs expressed concern that they have not been party to the discussions, which could see every family doctor in the country expected to carry out a rapid assessment of all their patients.
Professor Martin Marshall, the chairman of the Royal College of GPs, said: "It's vital that, as soon as any decisions are made about reintroducing shielding, these are clearly communicated to GPs in the areas that are affected, along with clear guidance about the role they will play in implementation.
"GPs and our teams will likely be the first port of call for patients with queries about whether they should shield or not, and why, so it's important that we are as informed as possible so that we can offer them appropriate advice and support."
Gemma Peters, the chief executive of Blood Cancer UK, said the charity would welcome clear advice, tailored to the risk in each individual area. When Britain entered lockdown, those with blood cancer were supposed to be issued with advice to shield. But more than a month later, one in three had not received a letter, the charity found.
Ms Peters said: "Last time, the NHS did a bad job of letting people with blood cancer know they were at high risk, and some people were never told they should be shielded. It needs to do much better this time.
"The Government also needs to give people with blood cancer who can't work from home the financial support to be able to shield if they want to. It won’t be enough for them to just be able to claim statutory sick pay, as this would force some people to choose between their finances and their health."