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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.’