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April 2018

CQC updates advice on staff immunisation



The Care Quality Commission has issued updated advice to ensure that all practice staff who are in contact with patients are up to date with mandatory vaccinations.

The update was prompted by queries to the Commission about GP practices’ role in ensuring staff immunity.

The latest edition of ‘Nigel’s Surgery’ states:

Practices must ensure that staff receive the immunisations that are appropriate their role, in order to protect:

– The individual and their family

– Patients and service users, in particular vulnerable and immunosuppressed individuals

– Other healthcare staff, and to

– Ensure the efficient running of services without disruption.

The CQC says GP practices should be able to show that an effective employee immunisation programme is in place. This includes demonstrating how they arrange and pay for this service.

In addition, all employees should be able to have an occupational health assessment, and new employees should have a pre-employment health assessment which should include a review of their immunisation needs.

The 'Green Book' Immunisation Against Infectious Diseases gives information on immunisation for employees in general practice. Guidance is provided on the immunisations that may be appropriate for different groups of staff depending on their role and place of work.

Everyone who has direct contact with patients, including reception staff, should be up to date with their routine immunisations:

  • Tetanus
  • Polio
  • Diptheria
  • Measles, mumps and rubella (MMR).

Some staff may need further vaccinations:

  • Bacillus Calmette–Guérin (BCG) if they have close contact with infectious tuberculosis (TB) patients.
  • Hepatitis B if they:

– have direct contact with patients’ blood or blood-stained body fluids, such as from sharps

– are at risk of being injured or bitten by patients.

  • Varicella (chickenpox) if they have direct patient contact and:

– cannot give a definite history of chickenpox or shingles or

– a blood test does not show they are immune.

Staff directly involved in patient care should also have the annual flu vaccine, but this is not routinely recommended for non-clinical staff.


It includes the recently introduced hexavalant vaccine for children aged 8 and 12 weeks, and introduces HPV vaccination (Gardasil) for men who have sex with men (MSM) up to and including 45 years of age. The new schedule is effective from Spring 2018.

April 2018