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GPs told to work with secondary care to ensure people with severe mental illness get Covid vaccine

GPs told to work with secondary care to ensure people with severe mental illness get Covid vaccine
By Alex Turner
16 February 2021

GPs have been told to work in partnership with secondary care mental health services and voluntary-sector organisations to ensure people with severe mental ill-health can access a Covid vaccination.

A letter issued by NHS England over the weekend (13 February) said local vaccination sites led by primary care networks (PCNs) should ‘focus their efforts’ this week and next week on inviting clinically vulnerable individuals from priority cohort six for Covid jabs.

‘Building on the outstanding success general practice has already shown in targeting vaccines for the clinically extremely vulnerable, it makes sense now to ask PCNs to focus on this JCVI group 6 given the relationship between general practice and those with long term conditions, and your important role in maintaining continuity of care,’ the letter said.

Under the Joint Committee on Vaccination and Immunisation’s (JCVI) advice, group six includes people aged 16 to 64 with chronic underlying health conditions, as well as adult carers and younger adults in long-stay inpatient and residential settings.

It also covers those with severe mental illness – defined as schizophrenia, bipolar disorder or any other condition ‘that causes severe functional impairment’ – and chronic neurological disease, including severe and profound learning disabilities.

‘Clinical discretion’

The letter advised GPs to ‘use clinical discretion to ensure the right people who meet the severe and profound learning disability definition are on the register’.

It acknowledged that there may be gaps and inconsistencies in how people’s learning disabilities are recorded and said the NHS ‘needs to make an extra effort to put this right’.

‘Alongside this the NHS is asking our key stakeholders and our voluntary and third sector partners to encourage people who have a severe and profound learning disability to come forward to their local GP,’ the letter said.

‘GPs should then assess the individual and if appropriate, add them to the list to be vaccinated.’

NHS England advised GPs to take a similar approach for people with severe mental illness, ‘working in partnership with secondary care mental health services and VCS partners to ensure appropriate outreach mechanisms are in place’.

Asthma patients

The letter also set out guidance on which asthma patients should be vaccinated in priority group six.

It said individuals included in the cohort would be limited to those who had previously had an emergency hospital admission for their asthma or who have had regular steroid prescriptions.

Some other people with very severe asthma, who have been shielding, have also already been included in vaccine priority group four, the letter said.

Sarah Woolnough, chief executive of Asthma UK and the British Lung Foundation, said previous government advice that people with asthma are clinically vulnerable to coronavirus had left many expecting that they would be included in cohort six.

‘Based on evidence that a lot of people with asthma are at no increased risk of dying from coronavirus, [the Government] has changed the eligibility for category six, which means many people with asthma no longer fall into this group,’ Ms Woolnough said.

She called on the Government to ‘urgently communicate directly to people with asthma why it has made this decision and explain the reasoning behind it’.

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