The BMA has called for more equal access to Covid-19 vaccination for NHS doctors working on the frontline, amid reports hospital admin staff is being prioritised ahead of patient-facing GPs.
In a letter to NHS England chief executive Sir Simon Stevens, the BMA warned it was ‘deeply worrying’ that access was not equitable across the health service and there seemed to be no consistent or systematic approach to vaccinating GPs and their staff.
Those at highest risk from the virus must be given priority in the vaccine roll out especially when we are seeing a ‘dramatic escalation’ in the number of cases, said BMA chair Dr Chaand Nagpaul.
The letter comes as GPs expressed frustration that non-frontline hospital staff were being given access to the Pfizer/BioNTech Covid-19 vaccine ahead of primary care.
Doctors Association UK have also written to health secretary Matt Hancock over concerns that many frontline staff, including GPs, have not heard anything about when they would be vaccinated.
NHS England had advised GP sites administering the jabs to give spare leftover jabs to staff members identified as being most at risk.
But other frontline GPs have been told by their CCGs that they were not yet a priority.
GPs in Surrey, Nottinghamshire and Cardiff were among those told they could not yet book a Covid-19 vaccine appointment despite it being freely offered to hospital staff.
In response to complaints about CCGs taking differing approaches on vaccination of primary care staff, NHS England director of primary care Dr Nikki Kanani said on Twitter: ‘Primary care staff absolutely can and should be vaccinated according to risk assessment.’
Guidance from the Joint Committee on Vaccination and Immunisation is that frontline health and social care workers are of top priority alongside care homes and those aged over 80 years old.
The advice is that ‘frontline health and social care workers at high risk of acquiring infection, at high individual risk of developing serious disease, or at risk of transmitting infection to multiple vulnerable persons or other staff in a healthcare environment, are considered of higher priority for vaccination than those at lower risk’.
Dr Prakash Kachhala, a GP in Nottingham, said there had been lots of confusion over risk assessment of healthcare staff.
‘Our CCG have told us that primary care staff should not book vaccination slots at our local hospital hub, despite some ringing the hub and being offered the vaccine and getting it done.
‘No risk assessments are being done to ensure the higher risk get it. It’s very worrying for primary care staff.’
Another GP in Nottinghamshire, Dr Shan Hussain, told Pulse he had written to the CCG expressing concern about the delay in primary care staff accessing the vaccine.
‘As GPs, we are front-facing and have been seeing patients throughout the lockdown (despite media reports to the contrary). And as you will know, over 90% of all NHS consultations occur within primary care.
‘Many of us are high risk, BAME, and have pre-existing medical conditions. The decision to delay our vaccination has not only placed our staff at risk compared to secondary care workers, but is also damaging to morale within the workplace,’ he said.
He received a response from the accountable officer agreeing that there was a need to prioritise the highest risk staff and teams were revising plans to ensure JCVI recommendations were met.
‘As the vaccine becomes more widely available, I think access to the vaccine will improve significantly. Thank you for everything you are doing to support our local health services,’ the response said.
Dr Lis Galloway, a GP in Surrey, said the CCG had told them there was no provision for GPs to be vaccinated yet.
‘It’s care home staff, hospital staff and over 80’s only. It’s terrifying given we are in the South East.
‘We are still tier 2 officially, but it’s only a matter of time before we move into tier 4 as in the rest of Surrey considering the number of positive swab results I’ve seen from the weekend.’
She said some GP colleagues had been vaccinated after walking into the hospital hub but others were turned away.
‘There is no consistency and as someone who is seeing Covid cases and with additional risks, it extremely disheartening to see hospital admin staff being prioritised over frontline health workers.’
A letter to general practice from Surrey Heartlands CCG apologised for any confusion but said the hospital hub had not been commissioned to deliver vaccines to primary care or community staff.
It said that when community vaccine sites had empty appointments they had been proactively phoning neighbouring GP practices and inviting staff in for the vaccine.
‘Unfortunately we are not yet in a position to offer a system wide vaccination service to primary care staff until the initial cohort of priority patients have been vaccinated.
‘However, as vaccine supplies increase in the New Year and as we open up the mass vaccination site/s we will ensure that GPs and patient facing primary care staff are contacted and offered an appt,’ the letter said.
Dr Zainab Najim, Secretary of the Doctors’ Association UK and a GP registrar criticised the lack of top down communication from the Department of Health over vaccination of front-line staff amidst news of a more transmissible strain of Covid-19.
‘Without a universal policy to vaccinate frontline patient-facing staff as a priority, and no review of current PPE guidance, we could be facing avoidable staff sickness and absence over the already difficult winter months.’