Updated advice in the NHS standard operating procedure guidance for primary care warns that staff in shielding groups must not see patients face-to-face irrespective of any risk assessment.
It adds that 'all other staff including BAME staff and people identified as clinically vulnerable who are asked to apply stringent social distancing should be risk assessed to consider if they should see patients face-to-face'.
The update follows sharp criticism from doctors' leaders and others of a Public Health England (PHE) review into the impact of ethnicity, obesity and other factors on COVID-19 outcomes.
BAME COVID-19 risk
The review confirmed people from BAME backgrounds were at increased risk from COVID-19, but failed to present solutions or practical advice for NHS workers or people working in other settings.
The updated operating procedure highlights a 'risk reduction framework for NHS staff' published by the Faculty of Occupational Medicine - and guidance from NHS Employers on risk assessments for NHS staff.
It adds that NHS staff can also be 'referred to an occupational health professional for further advice and support' - and suggests practices contact their local CCG for to be put in contact with their local occupational health service.
NHS guidance makes clear that staff at increased risk from COVID-19 should work remotely where possible and be supported to remain more than two metres from others within the workplace at all times where remote working is not possible.
Findings from the PHE review show that death rates from COVID-19 are highest among patients from BAME groups, reinforcing findings from earlier studies that suggested people from BAME backgrounds faced a two- to three-times higher risk of death.
BMA leaders called the review a 'missed opportunity'. The association's GP committee chair Dr Richard Vautrey told GPonline last week that it 'didn't take much' to understand that practical advice for primary care would need to involve safe working arrangements for those at risk and funding for locum cover if they were unable to work fully.