Nurses and other health professionals given powers to certify fit notes
New legislation has been introduced to allow nurses, pharmacists, occupational therapists and physiotherapists to certify fit notes. The change aims to take pressure off of GPs and cut bureaucracy. The legislation will apply in England, Scotland and Wales.
Fit notes – sometimes known as sick notes – are used when a person is off work for more than 7 days and provide evidence to employers about the absence and any relevant advice on how to support the person to remain in or return to work.
Minister for Patient Safety and Primary Care Maria Caulfield MP said: ‘Improving access to GP services and reducing unnecessary bureaucracy is vitally important as we tackle the COVID backlog. Extending powers to provide fit notes to other healthcare professions will relieve further pressures on GPs, and is another step towards helping to deliver an extra 50 million appointments in general practice a year by 2024.’
Minister for Disabled People, Health and Work Chloe Smith MP said: ‘These latest fit note changes recognise the valuable role other professions play in helping manage people's health, and I hope this will also help reduce unnecessary bureaucracy for doctors and general practice more widely.’
The extension of fit note certification follows changes made in April 2022 that allow for fit notes to be certified and issued digitally making the process more efficient.
Dr Gary Howsam, Vice Chair of the Royal College of GPs, said: ‘This move should help free up GPs' time to deliver patient care to those who need their medical expertise at a time when the profession is working under intense workload and workforce pressures. It also recognises the role of some members of the wider practice team in giving patients advice about health and work, and it's encouraging to hear that guidance and training will be put in place to help nurses, occupational therapists, physiotherapists and pharmacists ascertain whether this task is in their scope of practice, and support them to do this safely and effectively.’
GP surgeries to provide specialist mental health support
Mental health services will move closer to home for many patients, with appointments being provided in general practice. The NHS has announced it is providing funding for two mental health practitioners for every group of GP practices in a local area – meaning up to 2500 new staff will be employed. The announcement comes after the number of adults referred to community mental health services has increased by nearly one-fifth since the start of the pandemic.
The introduction of the new roles will see primary care and mental health trusts working together to offer one single service to patients, while GP time will be freed up to focus on routine care.
NHS chief executive Amanda Pritchard said: ‘Thousands more mental health experts working as part of family doctor teams, is a major boost for the NHS' drive to integrate physical and mental health care and will not only mean more people get better care, but crucially will help hard-working GP teams to provide the best possible care for their patients.’
Dr Nikki Kanani, GP and medical director for primary care at NHS England said: ‘As a GP, I have seen first-hand the significant impact of the pandemic on the nation's mental health, with far more people coming forward for support. So, it is fantastic that up to 2500 more mental health practitioners will be available to work with us, as part of joined up teams in primary care, to offer patients faster access to specialist mental health support through their local general practice team.’
The introduction of mental health experts in GP surgeries has already seen success in Teesside where two mental health nurses saw more than 1600 patents over 6 months in GP surgeries.
COVID-19 vaccines ‘prevented 20 million deaths in the first year of the programme’
In the first year of the vaccination programme, 19.8 million out of a potential 31.4 million COVID-19 deaths were prevented worldwide, according to a study published in The Lancet Infectious Diseases.
The study estimates a further 599 300 lives could have been saved if the World Health Organization's target of vaccinating 40% of the population in each country with two or more doses by the end of 2021 had been met.
Dr Oliver Watson, lead author of the study, said: ‘Our findings offer the most complete assessment to date of the remarkable global impact that vaccination has had on the COVID-19 pandemic. Of the almost 20 million deaths estimated to have been prevented in the first year after vaccines were introduced, almost 7.5 million deaths were prevented in countries covered by the COVID-19 Vaccine Access initiative (COVAX). This initiative was set up because it was clear early on that global vaccine equity would be the only way out of the pandemic. Our findings show that millions of lives have likely been saved by making vaccines available to people everywhere, regardless of their wealth. However, more could have been done.’
More than three quarters (79%) of deaths prevented were due to the direct protection against severe symptoms provided by the vaccine, leading to lower mortality rates. The remaining 4.3 million averted deaths were estimated to have been prevented by indirect protection from reduced transmission of the virus in the population and reduced burden on healthcare systems, improving access to medical care for those most in need.
Prof Azra Ghani, Chair in Infectious Disease Epidemiology at Imperial College London: ‘Whilst the intense focus on the pandemic has now shifted, it is important that we ensure the most vulnerable people in all parts of the world are protected from ongoing circulation of COVID-19 and from the other major diseases that continue to disproportionately affect the poorest. Ensuring fair access to vaccines is crucial, but requires more than just donating vaccines. Improvements in vaccine distribution and infrastructure, as well as coordinated efforts to combat vaccine misinformation and improve vaccine demand, are needed. Only then can we ensure that everyone has the opportunity to benefit from these life-saving technologies.’
‘Structural racism’ causing nurses to be overlooked for promotion, RCN study finds
Royal College of Nursing (RCN) survey found that white nurses were twice as likely to get promoted as black and Asian staff. The UK-wide survey of nursing staff with nearly 10 000 respondents was unveiled at RCN Congress 2022.
The survey found white nursing staff and those of mixed ethnic background across all age groups were more likely than black and Asian colleagues to have received at least one promotion since starting their nursing career. The difference appears most stark among those aged 35–44 years old. While 65.9% of white and 64% of respondents from mixed ethnic backgrounds within this age group said they had been promoted, this dropped to 38.3% of Asian and 35.2% of black respondents.
The survey also found that black respondents working in both hospital (38.9%) and community (31.6%) settings are more likely to face the need to report having experienced physical abuse than those of other ethnic backgrounds.
Bruno Daniel, the RCN's diversity and equalities co-ordinator, said: ‘These examples of racism experienced by nursing staff in the workplace are deeply shocking. The pandemic has shone a spotlight on structural racism in health and care services and we must seize this opportunity to stamp out this vile behaviour once and for all. The UK Government and devolved administrations must properly acknowledge and address this problem and the devastating impact it has on Black and ethnic minority staff and patients.’