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Government considering relaxation of GP practice infection control guidance


By Caitlin Tilley
30 September 2021

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Covid infection control guidance in GP practices is under review and could be relaxed, the health secretary has signalled.

The news comes as the UK Health Security Agency (UKHSA) this week [27 September] announced changes to infection control guidance in elective care settings.

The changes come in a bid to ‘ease the pressure created by the pandemic on NHS capacity over the next few months’, the Government said.

And, accepting the guidance, Sajid Javid has said he ‘look[s] forward to their [the UKHSA’s] assessment of what further steps can be taken in other healthcare settings including in primary care.’

As of the 27 September, a negative PCR and three days self-isolation is no longer required for patients undergoing selected elective care procedures, UKSHA said.

Under the new guidance, fully-vaccinated, asymptomatic patients in low-risk groups only need a negative lateral flow test on the day of their procedure. 

Patients who have been in contact with a positive Covid case must still get a PCR test to show they are negative, however.

It is the ‘first step’ in reducing IPC measures in healthcare, and ‘further changes looking at other services and environments… will be planned in future steps’, UKSHA said.

The new recommendations also include:

  • Reduction in social distancing from two metres to one metre ‘where patient access can be controlled’, for example not in emergency departments (matching World Health Organisation guidance);
  • Reverting to ‘standard rather than enhanced’ cleaning routines (due to the current limited evidence on Covid transmission via surfaces, as stated by WHO).

Staff working areas with newly-relaxed Covid control measures should be fully-vaccinated, asymptomatic and not a contact of a positive case. They must also maintain adherence to the current guidance on asymptomatic testing.

Dr Jenny Harries, UKHSA chief executive, said: ‘We have reviewed the existing Covid-19 IPC evidence-based guidance and made a series of initial pragmatic recommendations on how local providers can start to safely remove some of the interventions that have been in place in elective care specifically for Covid-19.

‘This is a first step to help the NHS treat more patients more quickly, while ensuring their safety and balancing their different needs for care.’

Mr Javid said: ‘[W]e can now safely begin to relieve some of the most stringent infection control measures where they are no longer necessary to benefit patients and ease the burden on hardworking NHS staff.

‘I thank Dr Jenny Harries and the UKHSA for their recommendations, and look forward to their assessment of what further steps can be taken in other healthcare settings including in primary care.’

Dr Layla McCay, director of policy at the NHS Confederation, said: ‘Healthcare leaders will welcome this review of the restrictions introduced during the early days of the pandemic. The recommended changes will help to increase efficiency and capacity within healthcare settings and give healthcare leaders and their teams the flexibility they need at a time when everyone is working so hard to increase the numbers of patients that can be safely diagnosed and treated.’

She added: The new guidance means opportunity to increase bed capacity on wards, an increase in patients being seen for a variety of procedures as well as the ability to transport patients more quickly and efficiently.

‘However, we must remember that Covid-19 has not gone away.  NHS organisations know this well and will not take their eye off the ball when it comes to infection prevention and control – not least as we approach what we anticipate will be a very difficult winter with the NHS affected by rising infections from Covid-19 to flu. The impact of this could lead to some organisations and systems having to adapt their IPC measures again depending on local need,’ she also said.

Must reflect ‘high Covid levels’

The BMA responded to the news by saying any new or updated GP infection control guidance must reflect ‘the high levels of Covid-19 circulating in the community’ and the ‘unique and varied general practice estate – including the size and layout limitations of many surgery buildings’.

Deputy chair of the BMA GP committee, Dr Mark Sanford-Wood, said: ‘For example, it would be hard for some premises to accommodate large numbers of patients even with reduced physical distancing. 

‘Safety must be front and centre and any new guidance must not be used to force through policies around access that would put patients and staff in harm’s way.’

He added: ‘Practices have been doing everything they can – working within the framework of national guidance – to provide care throughout the pandemic while keeping staff and patients safe through infection control measures.’

Earlier this month, the Government launched a consultation on making Covid and flu jabs mandatory for GPs and other frontline health staff.

A version of this story first appeared on our sister title Pulse.

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