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Nigel's surgery 37: Immunisation of healthcare staff
The COVID-19 vaccine is an important protective measure for both staff and patients of the practice. All staff should be offered and encouraged to have any of the approved COVID-19 vaccines in line with the latest government guidance.
Guidance on COVID-19 vaccines can be found in the Green book chapter 14a. It states that the objective aim of occupational immunisation of health and social care staff is to protect workers at high risk of exposure who provide care to vulnerable individuals. Potential exposure to COVID-19, and therefore the priority for vaccination, may vary from workplace to workplace. Guidance on COVID-19 immunisation that may be appropriate follows.
NHS England has produced Coronavirus (COVID-19) vaccine guidance for pregnant women and women of childbearing age.
Frontline healthcare staff are included in the government programme of vaccination. This includes the following groups:
Staff involved in direct patient care
Staff who have frequent face-to-face clinical contact with patients and who are directly involved in patient care in either secondary or primary care/community settings. This includes:
- midwives and nurses
- paramedics and ambulance staff
- occupational therapists
- staff working on the COVID-19 vaccination programme
Temporary staff, students, trainees and volunteers who are working with patients must also be included.
Non-clinical staff in secondary or primary care/community healthcare settings
This includes non-clinical ancillary staff who may have social contact with patients but are not directly involved in patient care. This group includes receptionists, ward clerks, porters and cleaners.
Immunisation of healthcare staff
This guidance relates to Regulation 12: Safe care and treatment.
Requirements for practices
GP 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 staff in general practice. Guidance is provided on the immunisations that may be appropriate for different groups of staff. This depends 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:
- 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.
When we inspect
We use these Regulations when we review if the practice is safe, effective, responsive, caring and well led. When we inspect, we look at the safety of staff. This relates to:
It is part of our Key Lines of Enquiry (KLOEs). In particular S1 Safeguarding and protection from abuse.
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
- Last updated:
- 01 March 2021