Survey to understand the provision of Travel Health in General Practice

On 2nd September  I opened a survey and closed it within four days as there were already 1052 responses, the majority (938) were collected within 48 hours.  Here is a snapshot of some of the preliminary results, although I have quite a bit more work to do on it. Thank you to the many of you who completed the survey, including more information and all the additional comments.  The survey was anonymous with the option to include your e mail (and I will be in touch privately in due course if you did this).   

Preliminary results from the survey

Some comments about initial results 

It was both interesting and reassuring that the majority who responded were still delivering travel health in their GP practices, although the results will have somewhat of a bias, since the initial request for responses were posted on my own Facebook page, which would attract readers who have an interest in travel health. Two other pages were used to post this request and these happened the following day, since the request to share the survey had to be accepted by the pages' administrators.  Both these pages are private access.  These were the General Practice Nurse UK page and the RCN General Practice Nurses Forum page.   

However 38 people said they weren't providing a service in general practice, when this is an essential service within the GP contract and should be available to all registered patients.  Sixty respondents said they were only giving the vaccines, but not performing a pre travel risk assessment or advice and 204 were using the system of one person risk assessing by reading the completed pre travel risk assessment forms then passing the task of vaccinating to a colleague.  

The majority of vaccines were administered using the National PGD templates (signed off locally) with 94% of the respondents saying they used this method, however this included many of those described in c. and d in the image above.  These methods could not be used to administer the vaccines using the PGDs though.  This aspect of the survey in point f. is concerning.  

Why did I create the survey?  

Well it was to obtain a picture of what may be happening, as I have many who contact me concerned they are being asked to undertake travel in a way they are not comfortable.  I am not trying to 'cause trouble' or make life even harder.  I appreciate the pressure in primary care is immense.  However, travel health and the NHS vaccines are given as a public health measure and the fact these newer working practices have been created to save time or because they have 'not been funded' puts the nurses at professional risk and violation of their Code.  All I'm trying to do it raise awareness and protect those of you who are unaware that administration of travel vaccines have to abide within the legislation of the tools you're using (in most cases the PGDs).

I have written an initial short article to explain the situation - please do read it  You can download it HERE.   

Article published in Practice Nurse Journal - Sept/Oct issue 2024 

If you subscribe to the journal it can also be accessed online here. 

I have a free course which again explains these scenarios, but also addressed two further situations.  The course would provide you with a certificate for one hour of learning and most importantly, leads to to the many references to back up the information I'm supplying.  Click HERE

Dilemmas in Delivering Travel Health - a one hour online course.  

Further information

The references within the article are also posted below for ease of access.

References:

1.      British Medical Association. gp-contract-agreement-feb-2020.pdf (bma.org.uk) (See 5.4); 2020 [Accessed 08.09.24]

2.      British Medical Association. Travel medication and vaccinations; 2022.  https://www.bma.org.uk/advice-and-support/gp-practices/vaccinations/travel-medication-and-vaccinations   [Accessed 08.09.24]

3.      Leicester, Leicestershire & Rutland Local Medical Committee Ltd; 2024. https://www.llrlmc.co.uk/focusontravelimmunisations  [Accessed 08.09.24]

4.      Royal College of Nursing: career and competence development; 2023 https://www.rcn.org.uk/Professional-Development/publications/rcn-travel-health-nursing-uk-pub-010-573   [Accessed 08.09.24]

5.      Royal College of Physicians and Surgeons of Glasgow.  Good Practice Guidance for Providing a Travel Health Service; 2020.  https://rcpsg.ac.uk/travel-medicine/good-practice-guidance-for-providing-a-travel-health-service  [Accessed 08.09.24]

6.      Donovan H, Green D, Jenkins J.  Best practice for medicines management and vaccination.  Practice Nursing 2022. https://www.magonlinelibrary.com/doi/full/10.12968/pnur.2022.33.11.465 

7.      NHN Specialist Pharmacy Service.  Introduction to PGDs – SPS – Specialist Pharmacy Service – The first stop for professional medicines Advice.   https://www.sps.nhs.uk/articles/introduction-to-pgds/  [Accessed 08.09.24]

8.      Office for National Statistics: Travel trends 2023 https://www.ons.gov.uk/peoplepopulationandcommunity/leisureandtourism/articles/traveltrends/2023#visits-abroad-by-uk-residents    [Accessed 08.09.24]

9.      UKHSA.  Immunisation training standards for healthcare practitioners; 2018. https://www.gov.uk/government/publications/national-minimum-standards-and-core-curriculum-for-immunisation-training-for-registered-healthcare-practitioners  [Accessed 08.09.24]

10. Care Quality Commission.  GP mythbuster 107: Pre-travel health services – Care Quality Commission https://www.cqc.org.uk/guidance-providers/gps/gp-mythbusters/gp-mythbuster-107-pretravel-health-services  [Accessed 08.09.24]

11. Nursing and Midwifery Council.  Delegation and accountability.   Supplementary information to the NMC Code   https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/delegation-and-accountability-supplementary-information-to-the-nmc-code.pdf [Accessed 08.09.24]

12. The Scottish Government.  Vaccination Transformation Programme – Travel Health Services; 2022.  https://www.publications.scot.nhs.uk/files/cmo-2022-13.pdf  [Accessed 08.09.24]

13. NHS England. NHS Vaccination Strategy; 2023. https://www.england.nhs.uk/publication/nhs-vaccination-strategy/ [Accessed 08.09.24]

I do hope this information helps you to understand the current situation.