BMA slams 'postcode lottery' in protecting at-risk GPs from COVID-19

GP practices have not received sufficient practical advice on protecting at-risk staff in the COVID-19 pandemic and face a 'postcode lottery' as approaches vary regionally, the BMA has warned.

Last month NHS Employers issued guidance on how health providers should carry out risk assessments for staff and provided information about actions to protect them.

GP practices were told to risk-assess members of the workforce from BAME backgrounds at the end of April in light of data suggesting they could be at increased risk from coronavirus.

But the BMA has highlighted concerns about variation in local approaches to risk assessment - and has argued that the protection of doctors should not come down to a ‘postcode lottery'.

COVID-19 pandemic

BMA GP committee chair Dr Richard Vautrey has also told GPonline that systems need to be put in place to help smaller surgeries protect at-risk staff while fulfilling requirements for face-to-face care.

The warning comes as over half of respondents in a recent BMA poll said they were not aware of any risk assessment in their place of work.

In a letter to NHS chief executive Sir Simon Stevens, BMA chair Dr Chaand Nagpaul said: ‘There is great variation locally in the use of and approach to risk assessments, both in secondary care and in primary care where, for example, occupational health services are not available to most staff.

‘To avoid a postcode lottery approach to the protection of doctors’ lives and health, a national system for assessing the level of risk facing individual doctors must be consistently applied across the NHS.’

Risk assessment

In recent weeks health organisations have developed risk-assessment tools to protect staff and manage services during the pandemic.

In Manchester a group of GPs have developed the country’s first risk register inclusive of ethnic origin to particularly prevent further deaths of staff from black, Asian and minority ethnicity (BAME) communities.

The safety assessment and decision (SAAD) scorecard, named after Bury GP Dr Saad Al-Dubbaisi - one of 11 GPs to have lost their lives to coronavirus - helps managers identify unsafe risk to staff members and plan to mitigate it.

It was reported earlier this month that people from BAME groups are two to three times more likely to die from coronavirus compared with the general population.

Occupational health

Dr Nagpaul said approaches like these could be used by NHS England to develop a national system for assessing risk levels facing individual doctors and called on CCGs to support GP practices with occupational health decisions.

Dr Vautrey told GPonline that smaller practices were facing ‘real challenges’ in protecting at-risk staff without large teams that could be moved around to enable at-risk clinicians to avoid face-to-face work.

‘If you’ve got a situation where your small number of clinicians are deemed to be at higher risk and need to step away from patient-facing consultations, obviously someone needs to do that if those consultations are necessary,' he said.

‘We've seen the development of shared arrangements in a primary care network (PCN) or locality, but that’s not always possible.

He added: ‘It's all very well doing a risk assessment, but you then need to have systems in place to actually respond to that assessment process, and as of yet we've not seen anything substantive around that and that's what is urgently needed.’

Prime minister Boris Johnson said on 20 May that more than 300 NHS and care workers have died from COVID-19. 11 GPs have lost their lives to COVID-19, with 10 from BAME communities.

Public Health England is set to report at the end of May on how ethnicity, gender and obesity affect COVID-19 risk, after the government accepted the need for an investigation into disproportionate deaths among people who are BAME.

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