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The waiting game

Practices can consider remote working or 'buddying' to get BAME GPs off frontline

Staff from black, Asian and minority ethnic backgrounds could work remotely during the Covid-19 crisis, while small practices may wish to get into 'buddying' arrangements with neighbouring practices if their GPs are at higher risk.

These were messages in a webinar on how to protect BAME GPs and general practice staff which took place yesterday evening, ahead of NHS England releasing a bespoke risk assessment tool for general practice.

And it comes as new data from the Office for National Statistics has shown that people from certain black, Asian and minority ethnic (BAME) groups are twice as likely to die from coronavirus than their white counterparts.

NHS England medical director for primary care Dr Nikki Kanani told GPs last night that practices should consider remote working for their staff who are at risk.

Some measures they can ‘start to consider’ include ‘looking at different working patterns, working remotely where that’s appropriate [and] using the back of office space in different ways’, she said.

She added that PPE has ‘an additional role to play in this space’ as ‘adapted PPE guidance’ is released.

Also speaking in the webinar, BMA council chair Dr Chaand Nagpaul added that PCNs should set up ‘buddying’ arrangements if doctors at small practices are at high risk.

He said: ‘If you are a small practice with just one or two partners, you may not have the same flexibility [as bigger practices]. That’s where I think within the PCN there need to be buddying arrangements so that some practices can be protected if the doctors there are at high risk.’

In some rural areas, practices with multiple sites have asked high-risk staff to work in sites where they are not exposed to ‘potentially infectious patients’, he added.

In the same online discussion, NHS England chief people officer Prerana Issar said that practices will have to have difficult conversations with their BAME staff in order to protect them, including over staff’s personal health information.

She said: ‘It is not an easy conversation to have. It is complex and it involves sharing your own health data with potentially your co-worker or your line manager - not an easy thing to do at all.’ 

The upcoming risk assessment tool will include whether staff have any co-morbidities such as hypertension, CVD, diabetes, chronic kidney disease and COPD, she added.

It comes as provisional analysis from the ONS, taking into account factors such as age and health conditions, found that the risk of death from coronavirus is ‘significantly higher’ for certain ethnic groups (see box).

Last week, NHS England said GP practices should risk assess their staff from BAME backgrounds in light of the emerging evidence that they are at higher risk from Covid-19.

It comes as seven GPs of BAME origin have died with Covid-19, among a total of eight GPs to die. All were male and over 50 years of age.

ONS: Black men twice as likely to die with coronavirus

The risk of death for those of black ethnicity is 1.9 times that of those of white ethnicity, taking into account ‘age and other socio-demographic characteristics and measures of self-reported health and disability at the 2011 Census’, the ONS said.

Men and women of Bangladeshi and Pakistani origin were also 1.8 and 1.6 times more likely respectively to have a Covid-19-related death than their white counterparts when these factors were taken into account, it added.

The ONS report said: ‘People of Bangladeshi and Pakistani, Indian, and mixed ethnicities also had statistically significant raised risk of death involving Covid-19 compared with those of white ethnicity.’

However, when taking only age into account, black men were 4.2 times more likely and black women 4.3 times more likely to die from coronavirus than white men and women. 

The ONS added: ‘These results show that the difference between ethnic groups in Covid-19 mortality is partly a result of socio-economic disadvantage and other circumstances, but a remaining part of the difference has not yet been explained.’

The ONS analysed deaths by ethnicity in England and Wales involving Covid-19 between 2 March and 10 April.

The Health Foundation said that ‘existing social inequalities and structural discrimination’ are likely to be playing a ‘significant role’ in the findings.

Assistant director of strategic partnerships at the Health Foundation Tim Elwell-Sutton said: ‘The Government has rightly launched an inquiry to understand the effects of Covid on black and minority ethnic communities, but in identifying the underlying causes, it must consider how deep-rooted discrimination and socioeconomic disadvantage are placing some people at increased risk.'

Readers' comments (15)

  • Rewrite the GP book, or close it. The access policy is flawed and should not be a patient's right. This could be the worst thing to hit the NHS beyond a virus, if honoured and self-sacrificing BAME staff, reconsider and step back. The NHS will disintegrate and no flawed PPE will be required.

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  • Maybe our rear echelon MFs can swap places with them, I bet they could do a better job than they do at the moment.Who is going to to all the patient facing work???This is a massive re deployment of the workforce.It is most probably undoable and will make the service collapse even in the current Covid times.

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  • With the sheer numbers of BAME Gp’s not seeing patients, who is going to see all the patients? Just imagine if this idea was implemented in hospitals - may as well shut the doors and turn the lights off. Sorry, but I’m busy enough with my own patients - I’’m not seeing someone else's as well. If they don’t want to do the work they can hire locums and pay them from their own profits. If i was a locum I’d be charging double rate as well for danger money.

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  • Gosh I’m quite shocked by some of the comments on this subject. Instead of showing concern about the significantly higher risks of dying from covid 19 for people of BAME background, there are complaints about the excessive workload for others and financial aspects IF BAME healthcare professionals were to be deployed away from the frontline??!! We all know in reality this isn’t going to happen; you are not going to suddenly have all BAME staff stop seeing patients but surely we should be thinking of extra safeguards that need to be put in place and where appropriate some staff may need to stop seeing patients for a period of time because of the added risk. Shouldn’t we all be supporting each other as healthcare professionals and be looking out for each other and advocating for the best safety standards for everyone ? If we know that certain groups are at increased risk should that not concern us?? It has often struck me that one of the great ironies of the “caring profession” is that at the end of the day we actually are terrible at caring for our colleagues. And sadly some of the comments here prove that.

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  • Agree we need to protect the most vulnerable. However we are going to have no workforce left soon. 60% of deaths are in men so is being male a factor that should be risk assessed too.

    Looking at GP deaths maybe it should be BAME doctors especially older males who really should be considering avoiding the highest risk work.

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  • Until doctor's honestly realise that the NHS system does not care about their mortality, doctor's will never put themselves first. They have been brainwashed that this is not 'in the best (perverse) interests of the (discriminatory) profession'. What would our treasured colleagues who lost their lives say to us?

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  • Where's Optimus?

    Often Doctors and nurses have good protection ...
    But admin and reception less so...
    BAME.. staff at all levels need safeguarding
    If there is inadequate PPE

    Universal precautions at all times for everyone

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  • Where's Optimus?

    It has often struck me that one of the great ironies of the “caring profession” is that at the end of the day we actually are terrible at caring for our colleagues.

    Hence the profession becomes salaried

    Hence Appraisals

    Hence malicious complaints

    Hence Abusive use of locums..

    Nothing new here..

    COVID could be the final nail for General practice..

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  • When and if it does finally take a grip in Africa , I wonder who will do the doctoring there ? What are the stats from America ? Anyone know if it’s just our BAME healthcare professionals who are susceptible and more likely to die ?

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