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Practice calendar: October

Our new monthly online feature looks at issues that crop up at particular times in the year. This month – should healthcare assistants be administering flu vaccinations? Our expert gives advice.

The problem

October kicks off the flu season in general practice. Many practices now use healthcare assistants (HCAs) to undertake flu vaccinations, to alleviate the pressure on GPs and nurse practitioners. However, the role of the HCA in general practice is a tricky one – are they competent to administer these vaccines to an increasing number of patients?

Expert advice

Before delegating the administration of flu vaccinations to a HCA, you need to ensure that he/she is competent to undertake this task and provide training and supervision (the latter by a qualified healthcare professional i.e. a nurse or doctor. This is in accordance with General Medical Council and Nursing and Midwifery Council guidance.

HCAs can legally administer medications, including vaccines, under a Patient Specific Direction. This is a written instruction by a doctor or nurse prescriber for a named patient, although it is not uncommon for it to be used to cover a list of named patients.

The HCA administering the vaccine is not making an assessment; he/she is working under the direction of the practitioner, who has written or signed off the direction and should have assessed the patient. The doctor takes responsibility for the instruction.

Doctors should inform their medical defence organisation of the extended role of the HCA to ensure that appropriate indemnity is in place.

All staff, including HCAs, administering vaccinations must be trained to recognise anaphylaxis. During the flu clinic when the HCA is administering vaccines, a doctor or nurse should be in the practice, to be on hand to administer in the event a patient has an anaphylactic reaction. This is because the HCA would not be in a position to treat the patient with adrenaline.

Julie Wilson is clinical risk programme manager at the Medical Protection Society,

Practice calendar


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