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Covid-19: Certifying status for “vaccine passports” must not increase GPs’ workload, says Royal College

BMJ 2021; 373 doi: https://doi.org/10.1136/bmj.n919 (Published 07 April 2021) Cite this as: BMJ 2021;373:n919

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  1. Abi Rimmer
  1. The BMJ

Any introduction of covid status certification or “vaccine passports” must have zero impact on GPs’ workload, the Royal College of General Practitioners (RCGP) has said.

In evidence submitted to the UK government about a possible covid status certification scheme, the college expressed concerns that involving GPs would intensify the workload pressures already facing the profession.1

The government called for evidence on covid status certification as part of its review into whether such a scheme might be used to reopen businesses and reduce social restrictions.

Covid status certification would use testing and vaccination data to confirm that people have “a lower chance of transmitting covid-19 to others.”2 It would be available to vaccinated and unvaccinated people who have been tested.

The government said it believed that in some settings—such as essential public services, public transport, and essential shops—covid status certification should never be required. But it said that certification could be used in settings such as theatres and nightclubs, as well as mass gatherings such as festivals and sport events, to help manage risks where large numbers of people are brought together.

The government said it expected that people would be certificated if they had either an up-to-date vaccine status; a negative lateral flow or PCR (polymerase chain reaction) test, taken at a test site on the day of their admission to a venue or the day before; or proof of natural immunity to covid-19.

Widening inequalities

In its response to the government’s call for evidence on covid status certification the RCGP said that, while it had no objections in principle to the development of a vaccine certificate or “passport,” the process must not add to GPs’ workload.3

The college said, “Any system put into place for vaccination certificates should have a zero impact on GP workload and thus ensure GPs can focus fully on patient care.

“We understand that initial planning for certification aims to use the NHS Digital data processing services dataset, which is positive in terms of having no impact on primary care IT. However, alternative solutions for those not digitally enabled, and for those requiring proof of exemption, must also be developed to ensure there is no addition to GP workload.”

The college said that, since general practice was often the first point of contact for patients, easy alternative routes must be in place for the certification process, such as a national helpline. It believed that certification should primarily be used to enable safe international travel because its use in the UK could create inequalities for certain patient groups where vaccine uptake was lower.

Martin Marshall, RCGP chair, explained, “Our concern about introducing certification for domestic use is that this risks negatively impacting on some patient groups more than others and by doing so widening existing inequalities, including health inequalities, in society.

“At the very least we would want to see a robust and accessible alternative to vaccination status certificates to ensure groups with lower than average vaccine uptake rates are not unduly disadvantaged.”

The covid status certification review has received over 50 000 responses from clinical and business experts.4 It closed for evidence on 29 March.

The government said that it would begin to pilot covid status certification in certain settings through its events research programme, an industry led steering group co-chaired by Nicholas Hytner and David Ross.

Pilots of the certification scheme will be run across a range of events, including the World Snooker Championship at the Crucible Theatre in Sheffield and the Circus nightclub in Liverpool, with the aim of admitting a maximum crowd of 20 000 to Wembley Stadium for the FA Cup final on 15 May. A second phase of pilot schemes will take place from the end of May.

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