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Clinical Update for Primary Care Team 9 February 2023

 1. Routine Covid-19 vaccination for people under 50 is ending

Adults under 50 in England have until 12 February 2023 to take up the NHS offer of a Covid-19 vaccination. After this date, only people in higher-risk groups under 50 are likely to be eligible for a Covid-19 vaccination. See https://www.bbc.co.uk/news/health-64496025

2. Medical examiner system

Implementation of the statutory medical examiner system will start from April 2023. Medical examiners are doctors who provide independent scrutiny of the causes of death. 

The purpose of the medical examiner system is to:

·         provide greater safeguards for the public by ensuring independent scrutiny of all non-coronial deaths

·         ensure the appropriate direction of deaths to the coroner

·         provide a better service for the bereaved and an opportunity for them to raise any concerns to a doctor not involved in the care of the deceased

·         improve the quality of death certification

·         improve the quality of mortality data

Medical examiners seek to answer three questions:

·         What caused the death of the deceased?

·         Does the coroner need to be notified of the death?

·         Was the care before death appropriate?

Medical examiners answer these by providing independent scrutiny, with three elements:

·         A proportionate review of relevant medical records

·         Interaction with the doctor completing the Medical Certificate of Cause of Death

·         Interaction with the bereaved, providing an opportunity to ask questions and to raise concerns

Implications for doctors completing death certificates:

·         Complete the death certificate accurately using the correct terms and sequence of causes.

·         Ensure the information in the deceased’s medical record supports the cause of death given on the death certificate.

See https://www.england.nhs.uk/establishing-medical-examiner-system-nhs/non-coronial-deaths-in-the-community/

3. Diagnosis and management of Monkeypox

An article published in the BMJ by myself and colleagues discusses the diagnosis and management of Monkeypox. See https://www.bmj.com/content/380/bmj-2022-073352

4. New NHS General Practice contract

Negotiations between the BMA’s GP Committee and NHS England about a new NHS General Practice contract in England have broken down, making it likely that NHS England will impose a contract unilaterally that the BMA views as unfavourable.

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