Practices have a legal reasonability under the Health & Safety at Work Act to identify hazards that any employee may face and put in systems to reduce the risk of harm to their staff, part of this is immunisations and infectious diseases.
As part of this Practices should ensure they have logged for each employee (clinical and non-clinical) their immunisation history or a risk assessment as to why this is not required. The list of vaccinations this applies to can be found via the web link below:
http://www.cqc.org.uk/content/nigels-surgery-37-immunisation-healthcare-staff. Further information can be found in Chapter 12 of the Green Book
Practices can choose to do the risk assessment themselves but can only vaccinate their own staff (ie provide an internal Occupational Health Service) if their MDO confirms they are indemnified to do so. Practices are strongly advised to check this with their MDO. To be clear, CNSGP (the state backed indemnity scheme) does not cover occupational health for staff employed by the practice. The alternative is to contract this out to another practice or provider. The costs of this, including the costs of any purchased vaccines are met by the practice as part of their employment costs of staff, apart from specific NHS schemes such as MMR.
For MMR we have produced some specific guidance as this is part of a national programme and can be found on our website at the bottom of the page titled “MMR For Practice Staff”.
We would advise that for any staff member over the age of 16 who has not received 2 doses of MMR they are eligible to receive the vaccine and this can be given by the patient’s own GP who are able to claim the fee for this. It should be noted that people born before 1970 are likely to have immunity from exposure or single vaccine but this doesn’t preclude them from having an MMR if in doubt.
When new members of staff join you may ask for a health questionnaire to be completed. At this stage you can ask for the immunisation history and a clinician assesses if any immunisations may be required. As previously mentioned, who administers these vaccines will depend upon the practice indemnity and may need to be commissioned from an alternative provider. If there was anything else identified on this which you feel requires an occupational health assessment, at this point you may wish to identify a service and refer them.
For other occupational health needs ie assessments there is no longer an occupational health service for practice staff (only for GPs) other than for needle stick injuries and so you would need to find a service to provide this for you.
NHSE have commissioned and fund Heales Medical to provide occupational health services for GPs only. This includes a number of services which are listed below that require no payment by the individual or practice:
- Health Surveillance for existing employees – online health surveillance screen
- Management advice – Assessment & reports
- Blood Tests – Immunity
- TB – IGRA/T Spot
- Anti Hbs/HBsAG
- Anti H.Bcore antigen
- H.Be Ag
- Anti HepCs
- Hep C RNA
- Hepatitis B
- BCG scar check
- Diptheria, Tetanus & Polio
Needle Stick Injury
Heales Medical provide a needle stick injury service for all members of staff. This includes a risk assessment, confidential advice and support following a needlestick/sharps injury.
To access this you need to call 03333 449 006 and this is available Monday – Friday 9.00 – 5.00 pm. There is recorded advice & a message service available outside of these hours.
Relevant information for needlestick injury and sharps can also be found on the following links
To access the services commissioned by NHSE as described above, you need to register with Heales Medical. This will ask you for an authentication/finance code which is your practice code e.g J12345.
Click here to register, the “Register your Clinic” button is at the bottom of the page
The Gov.uk website offer advise regarding Occupational Health Service providers and says:
Occupational health support can be very helpful in complex cases and when work may be affecting your staff’s health. Occupational health services are sometimes provided by NHS or local authority services. To find details of providers in your area, contact:
Safe Effective Quality Occupational Health Service : who offer a list of accredited occupational health service providers.