Daily Insight: Fit to practise? Definitely maybe

When the government U-turned on mandatory vaccines for NHS staff it left a lot of questions unanswered, but the one at the front of many healthcare leaders’ minds is what responsibility the regulators have.

The General Medical Council and Nursing and Midwifery Council have been clear: they are encouraging staff to take the covid-19 vaccine but do not consider it to be a fitness to practise issue alone if a staff member refuses it.

An NHS England webinar held last week has perhaps confused things somewhat. Jonathan Leach, medical director of the covid-19 vaccination programme, suggested vaccine status could be relevant in certain FtP cases, if a patient were to come to harm, for example.

Attendees clearly felt more clarity was needed from the regulators and chief nurse for England Ruth May agreed to take it up with the chief executive of the NMC. But as one commenter said, perhaps strengthening regulation could be more painful than the government mandate?

Diverting issue

The vast majority of diverts between accident and emergency departments – which NHS England says should be a “last resort” – are being reported by just two trusts.

Since December there have been a total of 201 recorded A&E ‘diverts’ – where a particular site comes under significant pressure and ambulances are temporarily directed to an alternative hospital.

Around 60 per cent of these were at just two trusts – Worcestershire Acute Hospitals Trust and University Hospitals Sussex Foundation Trust.

NHSE guidance says diverts of emergency patients due to lack of physical or staff capacity “should only need to happen in exceptional circumstances” when internal measures have failed.

While the trusts say the diverts help patients get seen more quickly, a patient safety charity has raised concerns about potential risk of avoidable harm.