GPs have raised concerns around an increase in workload as practices will have to report chickenpox cases to the UK Health Security Agency from April.
Following a Government consultation to ensure that regulations ‘meet current surveillance needs’, eight additional infectious diseases, including chickenpox, will be added to the list of notifiable diseases once new legislation comes into force on 6 April.
Yesterday, UKHSA laid out the changes in a webinar for GPs, explaining that it is ‘absolutely essential’ to have good surveillance systems in place for chickenpox to be able to monitor the effectiveness of a potential vaccine programme.
It comes after the Joint Committee on Vaccination and Immunisation (JCVI) recommended that a universal chickenpox vaccination programme is included in the routine childhood schedule.
But GPs raised concerns that having to report chickenpox will bring an increase in workload and that many cases could go undetected as patients ‘don’t usually go to a clinician with chickenpox’.
One GP attending the webinar described the change as ‘ridiculous’ and added: ‘This means every child will need reporting and many don’t present to the GP.’
Another GP said: ‘Could not the labs analyse the chickenpox immunity markers of cohorts of children instead of it being a GP task?’
According to the Government’s consultation response, published in December, only under half (47%) of those consulted thought chickenpox should be added to the list. Consulted parties raised concerns around the additional workload this could place on GP teams responsible for reporting notifiable diseases.
Eight new notifiable diseases
- Middle East respiratory syndrome (MERS)
- influenza of zoonotic origin
- chickenpox (varicella)
- congenital syphilis
- neonatal herpes
- acute flaccid paralysis or acute flaccid myelitis (AFP or AFM)
- disseminated gonococcal infection (DGI)
- Creutzfeldt-Jakob disease (CJD)
Source: Government consultation response
The Government said that, in response to these concerns, UKHSA conducted ‘further impact assessment’ on the impact of adding chickenpox on primary care workload and that they estimate the ‘overall burden’ for individual GP practices of this change ‘would be low’.
UKHSA is expecting less than 20 chickenpox notifications for an ‘average’ GP practice across the year, and said that this will ‘substantially decline’ once a vaccine programme is rolled out.
UKHSA’s consultant medical epidemiologist Gayatri Amirthalingam told the webinar: ‘With chickenpox, as it’s primarily a clinical diagnosis, we do not rely on laboratory confirmation.
‘We really do need good clinical notification systems, to be able to look at what the baseline burden of disease is and then be able to monitor the impact following a potential introduction of the vaccination programme.
‘I know some of you will be thinking this is going to add quite considerable burden in terms of your day to day activity.
‘I want to reassure you that as part of this process, there was an extensive assessment that was undertaken to try and understand what the burden of disease would be for individual practices, which actually at a practice level, was considered to be quite modest.’
Professor Azeem Majeed, a GP and head of the primary care department at Imperial College London, said the Government will need to ensure reporting does not create undue GP workload.
He told Pulse: u‘From a public health perspective, making chickenpox a notifiable disease will provide useful epidemiological data once the forthcoming national varicella vaccination programme starts.
‘Better surveillance will help policymakers monitor disease trends, assess the impact of vaccination, and identify outbreaks.
‘Many parents will self-manage children with chickenpox without seeking medical advice and so only a proportion will come to the attention of GPs.
‘However, I appreciate the concerns raised by GPs about the potential for increased workload. If the reporting process is overly complex or time-consuming, it could add pressure to already overstretched primary care services.
‘Therefore, it is crucial that UKHSA and the NHS ensure that reporting mechanisms are streamlined and do not place unnecessary administrative burdens on GPs.’
Sorry is this April 1st? What planet do these people reside on?
The decision to make chickenpox a notifiable disease is completely out of touch with the realities of general practice. Most cases are managed at home, so expecting GPs to track and report them adds pointless bureaucracy to an already overstretched system. The claim that this will only result in a ‘modest’ workload is laughable—practices don’t have spare capacity for unnecessary admin. If this data is so vital, why not use lab testing or another system instead of dumping yet another task on GPs? This feels like a knee-jerk decision with no regard for practical implementation.
Fortunately nobody ever told us about notifiable diseases, we don’t have any forms and I have not read this article.
It is impossible to accurately diagnose any of the new notofiable illnesses without laboratory confirmation so no notifications including chickenpox notification likely to occur as they probably don’t teach notification in medical and PA schools either!
Just ridiculous decision increasing potential workload with against expectations GP practices will absorb the costs.
For a self limiting disease, the quangos really have too much free time. What next? Report a cold or flu?