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GPs go forth

Primary care experts back redeployment of BAME staff away from the frontline

A group of experts has backed advice to redeploy staff from black, Asian and minority ethnic (BAME) backgrounds away from the frontline due to their increased risk from coronavirus.

Last month, NHS England asked practices to start ‘risk assessing’ their BAME staff on the basis of emerging evidence that they may be at higher risk from Covid-19.  

It said practices should make ‘appropriate arrangements’ to protect their staff, such as ‘working remotely or in a lower-risk area’.

Now a working group, led by professor of primary care at the University of Leicester Professor Kamlesh Khunti, has recommended the redeployment of high-risk staff to ‘lower risk environments’.

Primary care staff could be redirected to roles that are not patient-facing or avoid ‘direct contact in hot hubs’, according to a risk reduction framework developed by the group.

It said: ‘[Considerations] may include redeployment of those deemed at highest risk of adverse outcomes such as redeployment to lower risk environments. 

‘In primary care, roles which are not directly patient-facing are emerging and could be used as redeployment opportunities, or measures such as avoiding direct contact in hot hubs might be appropriate precautions.’

‘Supportive’ conversations around deployment between staff and managers should ‘take into account staff concerns and preferences’, it added.

Other measures include reducing the risk in the workplace through ‘safe systems of work’, correct use of PPE and hygiene measures, as well as identifying staff that are at higher risk.

Factors to be considered include age, sex, underlying health conditions or co-morbidities, pregnancy, disabilities and ethnicity, according to the framework.

The working group, which also includes Professor Trish Greenhalgh and Professor Azeem Majeed, professors of primary care at the University of Oxford and Imperial College London respectively, suggested BAME populations may be more at risk due to the higher prevalence of certain co-morbidities.

It said: ‘An emerging finding from systematic reviews and data from the UK is indicating that particular comorbidities such as hypertension, cardiovascular disease and diabetes are more prevalent in people with severe Covid-19. 

‘These comorbidities are also more prevalent in BAME populations and may explain the increased risk of morbidity and mortality in this group.’

It added that recent evidence suggests a BAME background and obesity ‘may be associated with increased vulnerability’, especially when combined with other risk factors.

However, ‘evidence for ethnicity as an independent risk factor remains uncertain’, it said.

It comes as nine out of 10 GPs known to have died from coronavirus come from a BAME background. 

Last week, NHS England and BMA said that practices can consider remote working or ‘buddying’ within PCNs to ensure their BAME staff are protected. 

Meanwhile, Public Health England is expected to publish the results of its rapid review into whether people of BAME backgrounds are more adversely affected by Covid-19 at the end of the month.

Readers' comments (9)

  • Quite late in the day as this has seemed pretty stark for many weeks. As with most of this crisis so far, waiting for expert advice and support leaves those at risk exposed and in limbo.

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  • What with NHS England vomiting out some new requirement on a near daily basis, how possible is this to achieve?

    The list of new "Covid related" non-contractual initiatives is doubling faster than err...covid itself, and let's remember GP wasn't exactly staffed well before. Each of these has some random arbitrary timescale for completion (sometimes over the bank holiday weekend).

    And that was prior to having to spend several hours a week listening to colleagues on Microsoft Teams adjusting their microphones or home-schooling the children.

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  • In 2 months NHSE will have hidden this one under the carpet, silenced the free thinkers and fudged any data. Tragedy. Elitist managers sending soldiers to shrapnel. Look after yourself, be doctor-centred in a new world, whatever your heritage. #opt out of pcn des.

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  • As far as I am aware there has been no or little mention of the prevalence of undiagnosed Primary Immunodeficiencies in our population, by race.
    I suspect there is a genetic factor behind many of the deaths of BAME people and healthcare workers.
    As well as age and viral load with or without PPE, and the other risk factors discovered so far.

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  • put women on frontline--men are at greater risk

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  • I'm sorry to say, I didn't find this guidance remotely useful.

    We all know what the risk factors are.

    What we need is consistency in how we implement them, like a scoring system.

    Without this, employers are left confused and workers are at risk of being exposed to areas they should not be working in.

    And I don't think the excess mortality in BAME communities is entirely down to obesity or co-morbidities.

    Diet and genetic factors are likely to be highly relevant.

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  • the saad asssessment tool has been published to address this issue. very useful and backed by references. we are using this to assess in our practice. shaba there is a scoring system with this. I have sent in a copy to pulse so that it could be uploaded to their site.

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  • shaba I have sent this to you on twitter as well.

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  • The relatively low prevalence of Covid 19 infections in may parts of Africa especially sub-Saharan areas has baffled many experts. What is the main difference between so-called BAME living in temperate climates and those living in their native environment? The role of vitamin D ( plenty of sunlight in Africa) and high humidity cannot be discounted. Those at highest risk in the UK also fit the profile for those at risk of vitamin D deficiency- older, pigmented skin ,pregnancy ,housebound , obesity those doing night shifts etc. A relatively young non obese population in Africa must be factors in reducing morbidity and mortality in Africa

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