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GP practices refused occupational health support for BAME risk assessments

EXCLUSIVE GP practices are being turned away by occupational health providers that say they do not have the capacity to provide support following Covid-19 staff risk assessments, Pulse has learned.

GP leaders in Lancashire have told Pulse they are aware of practices being ‘knocked back by providers they have initially been directed to’.

In other cases, GP leaders in several regions said while some practices are able to access the support – costing up to £300 per staff member – they are being forced to pay for it when they believe NHS England should be footing the bill.

The BMA’s GP Committee in England said it was ‘shameful if NHS England and some CCGs are not properly supporting practices’ and called for them to ‘properly fund’ the work.

GPs were asked by NHS England in June to complete risk assessments for at-risk practice staff within four weeks, including those from black, Asian and minority ethnic (BAME) backgrounds.

It followed a report by Public Health England that found people of Bangladeshi origin are most at risk of dying from Covid-19, while people from black ethnic groups are most likely to be diagnosed with the disease.

NHS England told Pulse it had commissioned occupational health services to provide support to GPs in line with a specification from 2016 and that CCGs should work with primary care networks and practices to ensure capacity for the service met demand.

However, Lancashire and Cumbria LMC chief executive Peter Higgins said: ‘NHS England was supposed to be procuring extra capacity for these occupational health assessments but the providers said they no longer had the capacity to do the work.’

The LMC has also discovered its local NHS England team will in any case not pay for the support provided to practices, despite doing so for NHS trusts – a problem that also affects Liverpool LMC.

Separately, Lincolnshire LMC told Pulse its practices are also not eligible to be funded for occupational health assistance due to a decision by the local CCG.

Lancashire and Cumbria LMC and Liverpool LMC have jointly written to North West NHS England primary care team, demanding that all health staff receive occupational health support that is funded by NHS England.

The letter, seen by Pulse, said: ‘We are compelled to challenge the regional stance proposing that such costs should be incurred by independent contractors and seek consistency of approach across the North West and that all health service workers are treated equally.’

The letter added that basic occupational health services under the 2016 service specification are ‘limited in scope’ and not guaranteed as they are still ‘subject to procurement’ in some parts of the North West.

It said: ‘This, coupled with the lack of timely communication with us directly to enlighten us on any additional capacity being made available in response to the current situation, has not helped matters.’

Mr Higgins told Pulse that the decision not to fund occupational health support for the risk assessments of GPs and other practice staff is ‘discriminatory’ towards practices.

He said: ‘You’re talking about £200 or £300 per assessment and it just seems to be discriminatory that primary care staff have to pay for it [when] if you’re in a trust or a community trust the cost is met.’

Lincolnshire LMC has also raised issues with its local CCG over the commissioning body’s decision to limit its funding for occupational health support.

LMC medical secretary Dr Kieran Sharrock told Pulse that while the CCG has commissioned the local trust’s occupational health department to provide support for GPs following risk assessments, this does not cover other practice staff.

He said: ‘Most of the time when you do a [staff] risk assessment it says they’re low risk, but for those people who are high risk, we do need occupational health support to get them back into work or working from home. 

‘Having to fund that ourselves isn’t really appropriate.’

BMA GPC England chair Dr Richard Vautrey told Pulse it is ‘vital’ that ‘appropriate action’ is taken to protect and support staff at increased risk from coronavirus.

He said: ‘As set out by NHS England, CCGs should commission an occupational health service for practices that need support with risk assessment and we believe at this critical time they should also do the right thing and properly fund this. 

‘It’s shameful if NHS England and some CCGs are not properly supporting practices and the frontline workforce at this critical time.’

A spokesperson for NHS England’s North West team said it had signposted practices to ‘available resources’ and would ‘offer them further support’.

They said: ‘In the North West, the regional team supported primary care organisations by signposting them to available resources and assisting them to draw down from the national framework where they determined a need.

‘In addition, we have set up a number of ongoing fora in which there is regular dialogue with LMC representatives in order to understand any challenges they are facing and offer them further support.’

A spokesperson for NHS England’s national team reiterated that CCGs should ‘review’ occupational health service providers’ current capacity and access to it and ensure practice staff know how to access support from their provider.

It comes as a BMA report published this week found that GP practices across the country are struggling to access occupational health support.

The report, looking at disability in the medical profession, said GPs ‘highlighted the additional difficulties they faced by not having access to the type of OH services that are available in hospital settings’.

It added that the over 100 GP respondents thought occupational health access should be a priority for improvements to support for disabled GPs, alongside careers advice, pensions and ill-health retirement.

NHS England previously told practices to risk assess all staff against coronavirus, including those from BAME backgrounds, in order ‘to consider if they should see patients face to face’.

In June, the BMA called for practices to have ‘urgent’ and funded access to occupational health services to support these risk assessments of all their staff.

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