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GPs should screen patients for MRSA, say public health officials

GPs should be expected to screen patients going into hospital for MRSA, even though they are often not funded to do the work, according to guidance issued by Public Health England.

The guidance says GPs should both screen for MRSA and carry out ‘suppression’ treatment in patients who test positive, if asked to do so by a hospital provider.

But GP leaders have criticised the guidance, pointing out that practices should not be expected to carry out the process as it involves a considerable amount of work that CCGs do not fund.

Public Health England re-issued the guidance, first published in 2007, which explains how GPs should manage MRSA screening.

It says: ‘GPs may be asked to screen and decolonise patients if, for example, a patient elects to have surgery outside their area. Hospitals may have local protocols that should be followed. If not, this guidance offers an evidence-based approach.’

The guidance forms part of Public Health England’s MRSA control strategy, aimed at preventing MRSA-colonised patients developing surgical site infections from their colonising strains and spreading infection.

But Dr Bill Beeby, deputy chair of the GPC’s clinical and prescribing subcommittee and a GP in Middlesborough, said in practice GPs were mostly expected to do the work without it being properly commissioned.

He said: ‘I would advise GPs to look carefully at whether to do this work unpaid. If the local commissioner wants GPs to perform this service rather than the provider chosen by the patient then they have got to make some adjustments and commission it.

‘[The commissioners] tend not to think through the consequences and the snag is the secondary care providers are always happy to just send us a little letter saying “please do this for your patient” as if it is all our responsibility.’

Dr Beeby added: ‘MRSA screening done properly is quite involved, it takes up a considerable amount of nurses’ time and who pays for that? My nurses work for my practice and not the secondary care providers.’

Readers' comments (7)

  • I think that GPC should issue guidance to the effect that public health should go around to people's houses and take out their bins.

    I know it's not their job, but the same notion doesn't stop them issuing guidance when it comes to us...

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  • This is a public health issue - in my view the work should fall within remit of Public Health England if secondary care opting out

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  • perfectly sensible idea, just fund it adequately and we can do it.Sadly what will happen is will be funded at say 65p a patient for year 1 then drop to 15p the next year -just as has happened here regarding referrals LES, equating to 2k loss in funding for 2 partner practice.

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  • No funding = No service . Does anyone provide OOH services for free ? I would be interested to hear.

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  • It also forms part of the care for secondary care as part of their tariff.
    Why pay twice?

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  • If screening is taking 2or 3 swabs to benefit the patient then no extra funding is needed.Practice nurses could easily accommodate the extra 2 minutes . GP's earn a decent salary and are becoming too financially focused.This general attitude is encouraging a task orientated profession loosing focus on patient centred care.

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  • Anonymous Practice Nurse
    Unfortunately I think you need to refresh your knowledge of infection control
    If a patient is suspected or found to have MRSA then you have to fully clean your treatment room after each of these patients which will take you 20-30 minutes in addition to the swabs- these are taken from 6 sites, have to be labelled and the request forms completed . If you can manage that in2 mins I assume you do blood tests in 30 seconds

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