GP leaders are alarmed that the proposed “COVID passport” scheme could require practice involvement in certifying certificates.
The government is currently consulting on proposals, suggesting that certificates could be used for major events. A certificate would confirm the holder had been vaccinated or had a test confirming positive antibodies or, potentially, a negative test for COVID in the preceding days. Critics have questioned how the scheme will be organised as well as raising ethical questions about whether people who have not been vaccinated should be denied services.
The Royal College of GPs confirmed it had made a specific submission seeking assurances that practices would not be involved in the process, warning it would “intensify worryingly high” workload pressures on practice staff. The most likely outcome would be that practices would be buried in “cumbersome” red tape, the college warned. It says that if the scheme goes ahead, GP representatives across the UK must be involved in developing its details.
It warned of unequal effects given low vaccination rates amongst some ethnic minorities.It also warned of problems of “digital inequality” and privacy if the NHS App is adapted to provide the certificate.
College chair Professor Martin Marshall said: : “GPs and our teams are currently working incredibly hard delivering the COVID-19 vaccination programme alongside the usual care and services our patients rely on. Whilst the College is not necessarily opposed to the introduction of some sort of opt-in proof of vaccination document to allow for international travel, it must not become the role of GPs and our teams to issue these.It would not be sensible for GPs, or any other members of the practice team, to spend their time on cumbersome red tape that will take them away from patient care.
“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. If a certificate is introduced then the idea of incorporating it into a digital platform, such as the NHS App, seems sensible as long as appropriate safeguards are in place to ensure confidential patient data is secure, particularly given that mobile phones may be susceptible to security breaches. Furthermore, measures would need to be introduced to minimise the risk of widening health inequalities. Alternative proof of vaccination must be available for those who don’t have smartphones or are simply less tech-savvy – and consideration must also be given to patients who have been unable to have a vaccination.”
Meanwhile the British Medical Association issued a warning about proposals to enable the population of England to be tested twice a week. The BMA warned of “false reassurance” from false negative tests.
BMA chair Dr Chaand Nagpaul said: “It is vital that the public is made aware of the limitation and accuracy of these tests. Recent research into lateral flow tests suggests they can pick up about over half of people with symptoms but significantly fewer of those who have Covid-19 but don’t have any symptoms. Further, there is evidence of even a lower detection of positive cases if people carry out the tests themselves.
“Therefore, negative tests could provide false reassurance to many people who have Covid-19 but do not have symptoms and who will be contagious. If they then mix more freely, that could be seriously counterproductive and rapidly spread infection. Given concerns about the level accuracy of these tests, the BMA believes the Government must therefore, proceed with caution and a negative test must not be used as a basis for people to mix without mitigations, but should only be used as a complementary exercise to other vital measures, such as social distancing and the wearing of face masks in public spaces. These tests must not be used as a mechanism of how to unlock the country.”