Workforce, Staffing and Occupational Health Considerations
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Occupational Health - Staff Flu
Practices may under the 2024/25 Seasonal Influenza ES offer their frontline patient- facing staff an influenza vaccination. This forms part of employer occupational health responsibilities and can be provided either by the employing practice or under other arrangements, for example through an occupational health provider or influenza voucher scheme with a community pharmacy.
Where eligible frontline patient-facing staff are administered an influenza vaccination by their employing practice, the practice will not be eligible for reimbursement of the influenza vaccine cost nor an IoS payment.
This is with the exception of where the eligible frontline patient-facing staff member is:
- eligible under the NHS influenza programme due to age or clinical risk AND is a registered patient at their employing practice, or
- a GP locum
With the exception of a GP locum as set out in section 2 of the additional guidance released on the 20 August, practices must not use the Immediate Necessary Treatment (INT) status to record influenza vaccinations administered to their eligible frontline patient-facing staff.
More about the correct use of INT can be found here
Options
As the practice will not be eligible for reimbursement of the influenza vaccine cost nor an IoS payment for Occupational Health activity, you could consider:
- Encouraging staff eligible for the NHS national seasonal influenza vaccination programme to attend their registered GP practice (or a community pharmacist) to obtain this immunisation. As you may not be aware whether staff are eligible; this should be given as generic advice.
- Heales Medical Group provides OH assessments, and vaccinations and immunisations for General Practitioners on the Medical Performers List and advice on exposure to blood borne viruses for all primary care staff (including General Practitioners).
- Your GP practices may have commissioned an Occupational Health Service for those staff not on the Medical Performers List; if this service offers seasonal flu immunisation, this service could be used.
- Practices can adapt the national PHE PGD and named nurse/s within the practice can then vaccinate practice staff; a GP within the practice needs to sign the PGD and thereby assume responsibility for this administration.
- Practices could purchase vaccination vouchers for staff.
Processes
- An appropriate registered clinician should generate a Patient-Specific Direction (PSD) for each staff member to be immunised.
- Keep a record of the immunisation.
- Ensure confidentiality of the staff members clinical information.
- Written Instruction for the administration of seasonal ‘flu vaccinations can be seen here.
Indemnity with GNSGP
Is flu vaccination by practice staff to practice staff colleagues covered by CNSGP
Yes. The Enhanced Service Specification: Seasonal influenza vaccination programme 2024/25 enabled practices to offer their frontline patient-facing staff working in general practice a flu vaccination, effective from 3 October 2024.
This covers frontline patient-facing staff who are registered with the GP practice as well as those who are not registered with the GP practice but who elect to receive their vaccination from the GP practice (therefore including peer to peer vaccinations).
As the service is offered and provided under the terms of the seasonal influenza vaccination enhanced service specification and therefore under a primary medical services contract (GMS, PMS, APMS or Schedule 2L provisions under an NHS Standard Contract), the activity falls within the scope of the Clinical Negligence Scheme for General Practice (CNSGP)
Anaphylaxis Training
Please see below for details of use and preparation for anaphylaxis when delivering flu vaccines.
The Community Pharmacy England guidance states that Pharmacists are required to include anaphylaxis pack as part of their preparation to provide the flu service in the pharmacy or offsite that is inclusive of care homes. They refer to the National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners.
Flu immunisation training recommendations (www.gov.uk) which also references the National Minimum Standards and Core Curriculum for Immunisation Training for Registered Healthcare Practitioners.
The RCGP produced advice and guidance for delivering Mass Vaccinations During COVID-19. * Please note this document has not been updated since July 2020.
Anaphylaxis training is available on the www.e-lfh.org.uk page Anaphylaxis - eLearning for healthcare (e-lfh.org.uk)
Remember to:
- Double check that anaphylaxis training is up to date and whether your resus protocols need to be adjusted due to Covid.
- Consider how equipment is transported for home visits
Infection Control PPE
National infection prevention and control Manual (NIPCM) for England
The NIPCM is an online Manual which is updated routinely, it has two primary Chapters which cover:
Chapter 1: Standard infection control precautions (SIPCs), including:
1.1 Patient placement/assessment for infection risk
1.2 Hand hygiene
1.3 Respiratory and cough hygiene
1.4 Personal protective equipment (PPE)
1.5 Safe management of care equipment
1.6 Safe management of the care environment
1.7 Safe management of linen
1.8 Safe management of blood and body fluid spillages
1.9 Safe disposal of waste (including sharps)
1.10 Occupational safety: prevention of exposure (including sharps injuries)
Chapter 2: Transmission based precautions (TBPs):
2.1 Patient placement/assessment of infection risk
2.2 Safe management of patient care equipment in an isolation room/cohort area
2.3 Safe management of the care environment
2.4 Personal protective equipment (PPE): fluid-resistant surgical masks (FRSM) and respiratory protective equipment (RPE)
2.5 Aerosol generating procedures
2.6 Infection prevention and control when caring for the deceased
Enhanced Hours
There is no restriction in the Enhanced Hours specification about the type of appointment that can be offered, it is permissive in terms of the nature of the healthcare professional whom the patient sees and the reason for the consultation. However, the appointments do have to be recurrent and consistent; that is, at the same time each week.
The LMCs do not believe that this means that the appointment type must be recurrent. The intention is to tailor Enhanced Hours to the specific needs of the patient and during flu season obviously there is a need for such appointments. In many cases it would be considered as custom for GP practices to offer ‘flu-clinics’ at times outside core hours, for example, at weekends. This would maximise uptake, improve patient convenience, and avoid some of the disruption that flu clinics could cause during normal hours. It may well be a reasonable to offer a proportion of Enhanced Access to be devoted to flu immunisations for a short timescale, perhaps a few months, during the flu season.
Section 9.12 of the Service Specification states ‘Practices must have the ability and capacity to deliver this ES. Appointments should provide maximum flexibility for patients and should be available at a range of times across the week including during enhanced hours, such as evenings and weekends to maximise influenza vaccinations to eligible cohorts.’
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Updated on Wednesday 23 October 2024
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