GPs may be required to provide evidence showing staff in care homes are medically exempt from mandatory Covid vaccinations, new Government guidance has suggested.
The Department of Health and Social Care released operational guidance this month on the new regulations that mean staff in care homes – or those visiting them, including GPs – will be subject to mandatory vaccinations.
It said there will be a ‘clear process’ for staff who believe they are clinically exempt and promised further guidance that ‘will help clinicians to verify exemptions’.
The BMA raised concerns two months ago that GPs would be expected to verify the requests.
In a bulletin sent to BMA members on 28 June it said: ‘The Government has said that a small number of people would be exempt and suggested that individuals may be directed to their GP to provide evidence, but we do not believe this should be the approach.’
The BMA said at the time that local councils should commission a dedicated service to assess exemption requests, without involving GPs.
It added: ‘This would provide a consistent approach and reduce further workload burden for practices. If the Government continues to suggest that GP practices should do this, we believe this will require practices to refer to a secondary care service for the necessary assessment as many of these patients will be receiving specialist care.’
The BMA has since told Pulse ‘ongoing discussions’ between the BMA and DHSC are taking place about the exemption process.
The BMA wants to ensure the activity ‘does not fall unnecessarily to GPs who are preparing for another very difficult winter’, it said.
The regulations, which apply to England and will come into force on 11 November, mean people entering a care home will have to show proof of a complete course of vaccination, not including boosters – unless they are exempt.
The DHSC’s operational guidance, released on 4 August, states that ‘for a small number of people vaccination is not appropriate due to clinical reasons’.
It said: ‘There will be a clear process for staff to follow if they think they may have a clinical reason to be exempt. This process will be aligned with certification for domestic events, exemptions from self-isolation for confirmed contacts and travel.’
It added: ‘We will be producing separate guidance for clinicians, which will align with guidance for vaccine certification in other public settings. This guidance will help clinicians to verify exemptions.’
A BMA spokesperson said: ‘The BMA is in ongoing discussions with DHSC around the process for agreeing medical exemptions, with a view to ensuring this work does not fall unnecessarily to GPs who are preparing for another very difficult winter alongside rising demand and practices struggling to recruit staff.’
The DHSC was approached for comment.
Meanwhile, NHS England last week published new guidance confirming that care home staff will ‘refuse entry’ to GPs or other healthcare staff coming into care homes who have no ‘evidence’ of two doses of an MHRA-approved Covid jab or a valid exemption from 11 November.
It said that GPs should ‘document’ the vaccination or exemption status of all staff to be deployed into care homes and ‘actively support’ staff to have their first jab by 16 September to ensure they are fully-vaccinated by the time the regulations come into force.
If staff refuse to be vaccinated without a valid exemption, GPs should conduct a risk assessment and make plans to ensure that ‘service disruption is avoided’, the guidance added.
It also reiterated that GPs should have ‘one-to-one conversations’ with any member of practice staff who has not had both doses of the vaccine to ‘establish reasons for vaccine hesitancy’.
Additional reporting by Costanza Pearce