With flu vaccination season upon us, you may be considering providing vaccinations to your practice staff. Kate Cowan, advisory case manager at Medical Protection, looks at the key indemnity and regulatory issues to consider
Medical Protection has received a number of recent calls requesting advice on performing flu vaccinations on practice staff when they are not registered patients at the practice.
While the decision is ultimately that of the practice and the practitioner administering the vaccination, there are important issues to consider, including your indemnity position and regulatory obligations. Relevant guidance is available from the GMC, NMC, RCN and NHS England, and we have provided a snapshot of the key points to take on board when deciding whether to provide flu vaccinations to your staff.
When making the decision whether to immunise practice staff, GPs need to consider the following GMC advice:
In paragraph 16(g) of Good Medical Practice it is stated: “In providing clinical care you must wherever possible, avoid providing medical care to yourself or anyone with whom you have a close personal relationship.”
In paragraph 14 of Prescribing and managing medicines and devices the GMC says: “You should prescribe medicines only if you have adequate knowledge of the patient’s health and you are satisfied that they serve the patient’s needs.”
In the same guidance, paragraph 19 states:
“If you prescribe for yourself or someone close to you, you must:
- make a clear record at the same time or as soon as possible afterwards. The record should include your relationship to the patient (where relevant) and the reason it was necessary for you to prescribe
- tell your own or the patient’s general practitioner (and others treating you or the patient, where relevant) what medicines you have prescribed and any other information necessary for continuing care, unless (in the case of prescribing for somebody close to you) they object.”
As members of nursing staff may be administering the vaccinations, they would need to ensure they are following the NMC code of conduct. Paragraph 18 states:
“Advise on, prescribe, supply, dispense or administer medicines within the limits of your training and competence, the law, our guidance and other relevant policies, guidance and regulations. To achieve this, you must:
18.1 prescribe, advise on, or provide medicines or treatment, including repeat prescriptions (only if you are suitably qualified) if you have enough knowledge of that person’s health and are satisfied that the medicines or treatment serve that person’s health needs
18.2 keep to appropriate guidelines when giving advice on using controlled drugs and recording the prescribing, supply, dispensing or administration of controlled drugs
18.3 make sure that the care or treatment you advise on, prescribe, supply, dispense or administer for each person is compatible with any other care or treatment they are receiving, including (where possible) over-the-counter medicines
18.4 take all steps to keep medicines stored securely
18.5 wherever possible, avoid prescribing for yourself or for anyone with whom you have a close personal relationship.”
The RCN also have helpful advice for nursing staff regarding flu vaccinations.
NHS England guidance
NHS England provided information about The national flu immunisation programme 2019/2020 in a letter dated 22 March 2019. This refers to the immunisation of staff at paragraph 7, which states:
“Vaccination is also recommended for frontline health and social care workers. This should be provided by their employer as part of the organisation’s policy for the prevention of the transmission of flu to help protect both staff and those that they care for. For frontline healthcare workers, a further letter about flu vaccination will be issued.”
Where a vaccination is administered as part of NHS contracted clinical activity, Medical Protection would normally expect this to be indemnified under the CNSGP scheme.
However, where the practice provides flu vaccinations to its own staff who are not registered as patients, this currently falls outside the scope of CNSGP indemnity. Medical Protection members administering such vaccinations are entitled to request assistance for any claims arising as a result, provided they are appropriately trained and competent to perform this activity, and are in the correct category of membership.
Those members or practices holding membership with Medical Protection that includes indemnity for claims arising from the acts/omissions of employees acting in the course of their employment can also look to us for assistance. As ever, the employee administering the vaccine should be appropriately trained and competent to do so and, where applicable, acting in accordance with delegated authority under the terms of a patient specific or patient group direction.
Practices involved in administering flu vaccinations for their staff should ensure protocols are in place covering:
- written instructions
- delegation in compliance with all applicable local or regional regulations or guidance
- training of staff involved in administering the vaccine
- vaccine dispensing and ‘cold chain’ transport
- obtaining consent
- dealing with any complications including anaphylaxis