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Published: 6 May, 2020

A round-up of the news for primary care


Assessing suitability for return to work

Many general practitioners and other primary care clinicians will be providing advice to patients who are concerned about their health status in returning to work under alert Level 3 or 2, or have been referred for advice from their employer. We have been unable to locate any documentation from the Ministry of Health to specifically guide this, other than general information about vulnerable patients. We are aware of a Risk Assessment Framework that appears to have been developed for DHB employees in March when the country was entering alert Level 4, however, it may be useful in general to aid decisions about the safety of a work environment for people with underlying health conditions. The RNZCGP has developed a “risk assessment matrix” based on this document.

Points to consider when assessing a patient's health risk in their workplace include:

  • People regarded as being at a higher risk of complications from COVID-19 include: those aged over 70 years, those with cardiovascular disease, moderate to severe respiratory disease, diabetes, chronic kidney or liver disease, chronic neurological disease, receiving cancer treatment, those who are immunocompromised, severely obese or pregnant – see bulletin #2 for further information on high risk groups
  • The nature of a person's work and their type of workplace influence risk, e.g. workers in healthcare, public-facing roles and large workplaces (e.g. factories) would be assessed differently to those working in individual settings with appropriate physical distancing (e.g. office workers, tradespeople)
  • The level of virus circulating in the community and national alert level influence risk, e.g. a person with an underlying health condition who was considered not safe to work at Level 4 may be able to safely return to work under Level 2 conditions
  • The number of underlying health conditions a person has cumulatively increases their risk, e.g. a person with mild asthma may be considered safe to work, whereas a person with mild asthma, diabetes and chronic kidney disease may not

Influenza vaccinations

In the last bulletin we reported that influenza vaccinations may now be offered to anyone who wishes to receive one, but those eligible for a funded vaccination should still be prioritised. This advice remains correct, however, supply and distribution issues have meant that many practices still have inadequate stock and therefore have to reserve any remaining vaccines for their most at-risk patients. The Immunisation Advisory Centre advises that vaccinations for children aged 6-35 months with Afluria Quad Junior should currently be reserved only for those eligible for funded vaccinations. The advice for practices who have run out of vaccines is to contact their local immunisation co-ordinator. Further shipments of vaccine are expected in the next week or two. However, it is unlikely that there will be enough stock to meet demand from the wider patient population, therefore vaccines will need to continue to be prioritised.

We understand that the influenza programme has caused an immense amount of stress and frustration to general practices. It is hoped that the issues that have arisen are used to inform the future approach to this programme. One of the key problems has been stock allocation, which we believe should be based on need, i.e. numbers of patients eligible for funded vaccinations per general practice, rather than on a "first come, first served" basis.

Dedicated phone line for COVID-19 clinical advice for Primary Care

The Ministry of Health has established a phone line for health professionals to seek advice about COVID-19 management in the community. The phone line is provided by Homecare Medical and staffed by primary care nurses, with a general practitioner, pharmacist and midwife also available. The purpose of the phone line is to access clinical advice – it is not for general operational issues, such as queries about equipment or funding.

The number is: 0800 177 622 (Monday - Saturday, 8am - 7pm).

This Bulletin is supported by the South Link Education Trust

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