This guidance relates to Regulation 12: Safe care and treatment.

Requirements for practices

Practices must ensure that staff receive the immunisations that are appropriate their role.

Immunising healthcare staff is necessary to:

• protect the individual and their family
• protect patients and service users, in particular vulnerable and immunosuppressed individuals
• protect other healthcare staff
• allow for the efficient running of services without disruption.

GP practices should be able to show that an effective employee immunisation programme is in place. This includes demonstrating how they arrange and pay for this service.

• all employees should be able to have an occupational health assessment
• new employees should have a pre-employment health assessment.

These assessments should include a review of their immunisation needs.

The 'Green Book' Immunisation Against Infectious Diseases gives information on immunisation for employees in general practice. Guidance is provided on the immunisations that may be appropriate for different groups of staff depending on their role and place of work.

Vaccinations for all staff in contact with patients

Everyone who has direct contact with patients, including reception staff, should be up to date with their routine immunisations:

• tetanus
• polio
• diptheria
• measles, mumps and rubella (MMR). This is particularly important to avoid transmission to vulnerable groups. Evidence of satisfactory immunity to MMR is either:
  • a positive antibody test to measles and rubella or
  • having two doses of the MMR vaccine.

Some staff may need further vaccinations:

• Bacillus Calmette–Guérin (BCG): if they have close contact with infectious tuberculosis (TB) patients.
• Hepatitis B: if they:
  • have direct contact with patients’ blood or blood-stained body fluids, such as from sharps
  • are at risk of being injured or bitten by patients.
• Varicella (chickenpox); if they have direct patient contact and:
  • cannot give a definite history of chickenpox or shingles or
  • a blood test does not show they are immune.

The annual influenza vaccine should be offered to staff directly involved in patient care. It is not routinely recommended for non-clinical staff.

Legal requirements

Requirements to protect staff and patients through appropriate vaccination are set out in:

• Health and Safety at Work Act (HSWA) 1974
• Control of Substances Hazardous to Health (COSHH) Regulations 1992
• Health and Social Care Act 2008 (Regulated Activities) Regulations