Updated guidance lists work GPs can pause to focus on COVID-19 jabs

The BMA and RCGP have listed services practices can pause and work that must continue in updated workload prioritisation advice for general practice.

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Guidance on workload prioritisation (Photo: Oscar Wong/Getty Images)

The advice comes after NHS England told practices to consider suspending routine and non-urgent care as the health service 'pulls out all the stops' to focus on delivering an accelerated COVID-19 vaccination campaign.

The college and the BMA said that a 'definitive list' of services that can be postponed in general practices was not possible - and that there was 'no one-size-fits-all' solution for the profession as a whole.

However, the guidance sets out a list of services that must be maintained - including consultations for suspected cancer and follow-up of two-week wait referrals, consultations with patients who are or believe themselves to be acutely unwell, flu vaccinations, wound management and management of long-term conditions in high-risk patients.

Non-urgent work

It also offers a number of potential services that could be suspended as practices divert their attention to the vaccination campaign - including non-urgent or routing screening and checks, non-urgent paperwork, minor surgery and complaints handling.

GP practices have been urged to redeploy staff to support an accelerated COVID-19 vaccination campaign that has delivered close to 6m jabs in the seven days from 13 to 19 December.

The scramble to step up vaccinations comes as the government warned the UK faced a 'tidal wave' of COVID-19 cases driven by the highly transmissible Omicron variant. Daily confirmed COVID-19 cases UK-wide are at record levels, totalling almost 600,000 in the past week alone.

However, GP leaders have warned that there are 'no easy decisions' when it comes to deciding what to prioritise in general practice - given intense demand for appointments exacerbated by a huge backlog in NHS care. GP practices in England delivered more than 30m appointments in October alone - a figure that rises to around 34m once COVID-19 jabs are factored in.

Tough decisions for GPs

BMA GP committee chair Dr Farah Jameel said: 'Patients will be understandably concerned that some appointments will need to be postponed in order to ramp up the booster campaign. GPs and their teams will do their best to continue to prioritise the care they offer alongside providing COVID-19 vaccines.

'But with ever-increasing demand on healthcare services and rising staff sickness rates, the unfortunate fact is there are not enough GPs and surgery staff to do everything for everyone all of the time, and we know many members of the public appreciate this.

'This guidance isn’t an instruction, nor is there a definitive list of activities practices should or should not do. The guidance does not replace expert clinical judgment, based on practice staff’s in-depth knowledge of their local populations, and ultimately it will be up to practices themselves to decide how to meet the urgent needs of their patients in a way that keeps both patients and colleagues safe.

'We cannot be clearer, however, that general practice is open, as it has always been, and any patient who has any worrying symptoms should continue to contact their surgery, where they will be advised accordingly, and patients who clinically need to be seen in person will be.'

Updated workload prioritisation guidance was promised as part of an NHS England update that urged practices to divert as much attention as possible to support the vaccination campaign. One practice reported on its website that a quarter of its clinical staff had been transferred to work on the vaccination campaign every day.

BMA leaders have called for COVID-19 restrictions to go further to slow the spread of Omicron - warning that 'relying entirely on the vaccine booster programme' is a mistake. The association has called for measures including the return of 2m social distancing requirements, increased requirements around face coverings, more limits on large indoor gatherings and changes to infection control measures in healthcare settings.

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