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GPs ‘given no guidance’ as 400 asylum seekers arrive from centre linked to diphtheria cases

GPs ‘given no guidance’ as 400 asylum seekers arrive from centre linked to diphtheria cases

Exclusive GPs in London have been left in the dark by the Home Office over plans for the arrival of 400 asylum seekers from the Manston asylum centre, which has been linked to an outbreak of diphtheria.

GPs working in the London Borough of Tower Hamlets told Pulse that they are happy to support asylum seekers, but the Home Office has provided no information on what medical intervention, if any, the group may have had for the disease.

They are also concerned that general practice will be left to deliver diphtheria vaccinations with ‘no extra funding or expertise’ at a time when it is already under extreme pressure.

This comes as the Home Office has already faced criticism over its handling of diphtheria at the Manston facility in Kent, which has reportedly been linked to around 50 cases of the disease.

In November, the UK Health Security Agency recommended ‘mass antibiotic prophylaxis and mass vaccination’ for diphtheria for all asylum seekers arriving at an initial reception centre and those who arrived to one after 31 October 2022 but had subsequently been housed elsewhere.  

But also that month a representative of the Prison Officers Association quoted in a Guardian article warned that it had ‘consistently raised concerns around the presence of diphtheria at Manston’ and ‘that people were being moved to hotels and onward accommodation without being tested’.

And the Association of Public Health Leaders issued a statement that said there had been ‘no direct engagement from the Home Office’ over the dispersal of asylum seekers from the centre and this had put ‘additional and preventable burdens on already stretched local health systems’.

Clinical director for the East End Health Network and Tower Hamlets GP Dr Spyridon Symniakou told Pulse: ‘We know that where they are at the moment there is still an active diphtheria outbreak and for some reason, we cannot get any information about whether they have had any intervention already, which they should have. We don’t know if they’ve had any antibiotics or vaccination.’

GPs have also not received information on when the group of 400 will be coming and what translator or interpreter support they may require, he said.

Dr Symniakou said that there is already ‘very good collaboration’ between local stakeholders, including the ICB, council and trust, but they are currently ‘driving blind’ without key information.

He added that it does not come under the general practice remit to provide an outbreak response ‘on its own’ and called on the Home Office and NHS England to provide adequate support.

‘Our practices are welcoming of asylum seekers in our area, and we will strive to provide the best service we can for them, but we definitely need funding and expertise in order to deal with the specific needs that they have, like the outbreak of diphtheria,’ he said.

An NHS England document seen by Pulse states that ICBs are currently responsible for commissioning and paying for health services for initial accommodation for asylum seekers.

It adds that NHSE also operates a contingency fund providing ICBs with £150 per new arrival to support registration with a GP practice and an initial health assessment, which should take an hour.

But on the diphtheria outbreak specifically it says that while UKHSA has ‘recommended outbreak response there is no funding mechanism attached to those recommendations’.

‘NHS England has advised ICBs to keep a record of additional cost incurred in response and if these do turn out to be material NHS England will look into these,’ the document says.

Dr Symniakou told Pulse there are concerns over existing funding for the provision of the asylum seekers local enhanced service in Tower Hamlets, and that the LMC is currently working with commissioners to rectify this.

Chair of Tower Hamlets LMC Dr Jackie Applebee said: ‘As a general practice community we really want to support asylum seekers and we understand how vulnerable they are. But we’re worried about it not being funded properly and them not getting the care they need.

‘We’re also worried about our capacity and what a huge influx of people will mean for our existing general practice provision if this is not resourced properly.’

A Home Office spokesperson said: ‘We take both the welfare of those in our care and our wider public health responsibilities extremely seriously; to suggest an outbreak has happened on site is untrue.

‘We work closely with the NHS and UKHSA to support any individuals affected by infection and limit transmission, as well as ensure information is shared in a timely way and that everyone leaving facilities such as Manston is given access to appropriate treatment.’

They added: ‘The Home Office provides 24/7 health facilities at Manston as well as having robust contingency plans to deal with health issues such as communicable diseases.’

Medics are at the Manston centre and are identifying and treating any cases of diphtheria, and there is an isolation ward on site to prevent contamination between residents. Diphtheria vaccinations are being offered to people at the centre, which has 24/7 health facilities and trained medical staff.

The Home Office is liaising with UKHSA regarding diphtheria cases and has a pathway in place to safely move individuals suspected or confirmed as having the disease to onward accommodation, if this is appropriate to support their isolation.

The UKHSA has advised that the risk of diphtheria to the public is very low due to high vaccine uptake in this country and because the infection is typically passed on through close prolonged contact with a case.



Please note, only GPs are permitted to add comments to articles

David Church 18 January, 2023 10:08 am

Medical staff at the Home Office should be responsible to GMC for management of the outbreak according to good public health standards, like case isolation and contact monitoring, and are required to provide adequate handover to the next medical attendant.
Did they not do this?
Who are they?
Not Dr Matt Hancock is it?

Hot Felon 18 January, 2023 3:53 pm