Flu spread by unvaccinated NHS frontline staff

Health workers have been blamed for putting vulnerable patients at risk and worsening the winter’s flu outbreak by refusing to have flu jabs. Fewer than one in seven frontline NHS staff had a flu jab last year, The Times has learnt, despite a recommendation that they do so. The Royal College of General Practitioners called last night for hospital doctors, GPs, nurses, carers and other staff to have compulsory jabs or be banned from contact with patients other than in exceptional circumstances. Figures to be published next week by the Department of Health will show that the vast majority of health professionals ignored government advice that everyone in direct contact with patients be immunised.

Of the hundreds of patients seriously affected by staff transmission of flu, some were infected while being treated in high-dependency wards.

The health department figures show that only 14 per cent of frontline workers had a flu jab before the 2008-09 season, despite warnings from Sir Liam Donaldson, the Chief Medical Officer for England, that immunisation rates had to improve.

The flu outbreak over Christmas and the new year was the worst for eight years, with more than 60 cases per 100,000 head of population. About 2,000 deaths are attributed to flu annually – although the number can rise to more than 10,000 in bad years. The number for this winter has not yet been released. Some hospitals suffered serious flu outbreaks exacerbated by staff transmission of the highly contagious virus, while shortages of workers put pressure on accident and emergency departments. Anecdotal reports suggest that on occasion patients brought to hospital by ambulance had to wait for up to five hours because staff were so overstretched by absenteeism and higher admission rates caused by flu.

At Royal Liverpool University Hospital, nearly 100 patients caught flu, including on high-dependency wards treating blood diseases and kidney problems.

Low levels of vaccination among staff were identified by the Health Protection Agency as a significant factor in the outbreak. When health chiefs in Liverpool asked any unvaccinated staff to get a jab to help to control the outbreak, almost 1,300 came forward. All frontline workers should be offered jabs through programmes run by health trusts from early October, at the start of the annual vaccination campaign. Uptake rates, which have been low historically, rose to close to 20 per cent of NHS frontline workers in 2005 but have fallen away since.

Dr George Kassianos, the immunisation spokesman for the Royal College, said it was incumbent on ministers and health leaders to make sure that patients were not put at greater risk from contact with the NHS. Dr Kassianos said that a form of compulsory vaccination – where anyone not wishing to have a flu jab should not be put in frontline roles unless under exceptional circumstances – should be considered. “The only way to boost the effectiveness of the flu vaccine is to immunise the people who are delivering the care – in hospitals, nursing homes, residential homes and GPs’ surgeries,” he said. “We are now so hot on infections such as MRSA, so why are we not on influenza? You are placing patients’ lives at risk if you give them the flu.

“It may make sense to say that if staff want to work in contact with patients, then they need to be immunised. We have to think of the patient on the hospital bed. They have a right not to contract flu from a carer.” Under the code of practice for health-care-acquired infections issued by the NHS, and monitored by the Healthcare Commission, trusts are required to “ensure, so far as is reasonably practicable, that healthcare workers are free of, and protected from, exposure to communicable infections”.

However, a study of NHS attitudes conducted by the Government last year found that most staff did not view flu as a serious illness and thought the vaccine unnecessary because they were not at risk. Trusts reported staff vaccine compliance as a “key problem area”.A conference was even held by the Department of Health last June for flu vaccine campaign organisers to improve NHS workers’ uptake.

Michael Summers, the vice-chairman of the Patients’ Association, said that the latest figures seen by The Times were “very concerning”. “NHS staff must lead by example. They know that patients are vulnerable to flu if they themselves are infected but also if they fall sick and have to stay at home, which will also affect patient care. They know the risks this is posing to patients.”

A health department spokesman said that the Government accepted that improvement was required, but mandatory vaccination was not being considered. [It should be a requirement of the job] “We want to see flu immunisation rates in healthcare workers increase because it will benefit both patients and staff. The recently published code of practice emphasises the need for NHS organisations to have an immunisation policy in place and to ensure staff’s immunisation status is reviewed and updated,” he said.

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Australia: Another glimpse of the nasty bureaucrats behind the trouble-prone Queensland Ambulance service

All they care about is power -- their own. So reasonable actions by ambulance officers that ran contrary to stupid bureaucratic directions get the officers punished. There has been nothing but trouble since the State government took the service over a few years ago. Bureaucracy always has the same deadening and stultifying effect

Two paramedics have been stood down from duty after refusing to risk transporting a sick baby to hospital because their ambulance had no child restraint. The Gold Coast case has sparked uproar in paramedic ranks, with claims of heavy-handed management by Queensland Ambulance Service bosses and "a culture of fear and intimidation".

Sources said the paramedics were called to a Tallebudgera Valley address on Thursday morning by the parents of a sick 10-month-old baby. They assessed the baby's condition as stable and the case non-urgent, and asked the communications centre to send a baby capsule so the baby could be transported safely to hospital. But sources said the paramedics were directed to take the baby to hospital anyway, which would have required the mother and child to be strapped to a stretcher together.

Instead, the mother opted to take the baby to hospital in her own car, which had a capsule. When the ambulance officers returned to the station, sources said they were told they had been stood down immediately for "disobeying a direction". "They were told to pack their things and leave and not return until further notice," a source said. "It was abysmal treatment and part of a culture of fear and intimidation in the QAS." The officers were reinstated four hours later after they contacted their union.

"It's an unbelievable way to treat caring and professional officers," said Prebs Sathiaseelan, the president of the Emergency Medical Services Professionals Association. "These paramedics were punished for acting in the patient's best interests. "There was absolutely no need to risk the baby's life by transporting it to hospital without a capsule. "The officers were given no explanation as to why they had been stood down. "They were made to feel guilty and inferior." One paramedic said the QAS was so short-staffed the decision not to send a baby capsule was likely due to manpower shortages.

A QAS spokeswoman said the two paramedics were stood down about 9am on Thursday for "disobeying a direction". She said the suspension was lifted four hours later after it was investigated. "QAS management have advised that no further disciplinary action will be taken," she said.

The spokeswoman said strapping a young child and parent in an ambulance stretcher was "standard practice" and capsules were suitable only for children aged up to six months.

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