Dr Alison George, of the Doctors’ Association UK (DAUK) GP team, criticised the decision not to ‘protect staff health’.

She was responding to the Joint Committee on Vaccination and Immunisation (JCVI) guidance that the age at which people are offered an NHS Covid vaccine should rise from 75 to 80 in autumn 2027.

Reducing vaccination

Dr George said: “Reducing vaccination to such a small group gives the impression to the public that we do not need to worry about Covid any more and that it can only harm the very oldest and most vulnerable in society.

“This is not the case at all and will do nothing to encourage members of the public to protect themselves and those around them from a disease that is spread easily.

“From an NHS staff member perspective it just confirms that DHSC and NHSE leaders have zero interest in protecting staff health.”

Dr Steve Taylor, DAUK GP co-lead, spoke to the BMJ about the guidance.

Vulnerable and marginalised

He said: “This issue with a raised age group again gives the wrong impression of the failure of the NHS to care for the vulnerable and marginalised.

“It also means some NHS staff will feel that their health doesn’t matter. This feels like cost cutting rather than genuine choice over health benefits and certainly affects staff at risk.

“As DAUK has said previously, it will backfire, with staff sickness and absences. This should be a choice for staff and older patients.”

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DAUK has warned that the Government is repeating past mistakes around public health messaging, preparedness, and transparency.

DAUK committee members have expressed unease at shifting public health guidance and what they describe as the ‘downplaying’ of transmission risks by the Government.

Public health information

Indeed, DAUK committee members highlighted recent changes to official public health information, including the removal of references to aerosol transmission.

Dr Steve Taylor, DAUK GP co-lead, said: “It is deeply concerning to see language around transmission being softened or altered in real time.

“We went through the pandemic where delayed recognition of airborne spread had devastating consequences. To see the same thing happening again is alarming.”

Dr Alison George, DAUK committee member and a GP in Newcastle, said that university students frequently travel between campuses, social settings, and family homes, which risked the spreading of the disease outside of Kent.

Bigger picture

Limiting focus to isolated clusters risks underestimating the broader spread, she said.

Dr George said: “Students mix, travel, and interact across universities all the time.

“To frame this as a localised issue without wider preventative action risks missing the bigger picture entirely.”

Dr George warned the situation bears uncomfortable similarities to early pandemic decision-making, where concerns about economic and social disruption appeared to influence public health messaging.

Covid Inquiry

She said: “The Covid Inquiry has already revealed that key decisions were shaped by economic considerations rather than purely public health needs.

“We are worried that the same tensions are playing out again, and that the desire to avoid disruption is taking precedent over public health.”

Dr George raised concerns about preparedness, including vaccine availability and public health information, drawing parallels with early shortages of personal protective equipment (PPE) during Covid-19.

Precautionary approach

DAUK is urging health authorities to adopt a precautionary approach, including:

• Clear and consistent communication about transmission risks
• Consideration of wider spread beyond initial clusters
• Rapid assessment of vaccination strategies for at-risk populations
• Transparency in how public health decisions are made

We are a non-profit campaigning and lobbying organisation led by frontline doctors, for frontline doctors. We are volunteers and our collective aim is to give frontline workers a voice to be heard.

Please support our work by contributing to our crowd funder.

Despite clear signs of a rapidly spreading global pandemic, which NHS staff watched with horror as the world locked down, the UK death toll was rising with no restrictions in place.

Contact tracing was abandoned in early March 2020, and large gatherings continued to take place up until the end of that same month.

The Covid Inquiry report reveals that if the government had introduced the first lockdown a week earlier, 23,000 people in England alone would not have died.

DAUK’s Protect the Frontline campaign, collaborating with Led by Donkeys called for adequate PPE for NHS staff.

PPE supply

Thousands of doctors signed up to our NHSPPE app giving daily reports on the PPE supply they had access to. We also raised our concerns that staff were being discouraged from speaking up about PPE in the press.

Dr Ellen Welch, DAUK co-chair and author of How the NHS coped with Covid-19, said: “Frontline staff were left woefully unprotected by a lack of PPE, and DAUK provided a voice for doctors to speak up about this when many felt gagged by their trusts.

“We all saw colleagues don homemade PPE to go to care for patients and two months later nearly 300 healthcare workers had died.

“DAUK welcomes the recommendations of the inquiry and hopes lessons have been learned around the key theme of preparedness.

“Future pandemics will come and it would be an insult to those who lost their lives, or continue to live with long Covid, if we did not.”

Covid Airborne Transmission Alliance

DAUK is a member of the Covid-19 Airborne Transmission Alliance (CATA), which gave testimony as part of the inquiry about how UK healthcare officials systemically denied overwhelming scientific evidence that Covid-19 was airborne.

Watch CATA chair Dr Barry Jones giving evidence here.

Dr David Nicholl, consultant neurologist and DAUK committee member, said: “I was thinking how much of a media hullabaloo there was, rightly, over the Iraq War when there were 179 UK deaths, yet how quickly there has been a concerted action to move along from the pandemic by the media.

“There were more than 200,000 deaths from Covid, including hundreds of healthcare workers. Some like Boris Johnson clearly don’t want to learn.”

Dr Welch added: “As another winter takes hold, NHS staff approach it this year without the protection of the covid vaccine.

Covid Inquiry report

“The Covid-19 Inquiry report should serve as a reminder to those in power of the damage wielded by this virus, and urge them to start implementing measures now to protect staff and patients, such as vaccinations, masks, ventilation to name a simple few.

“Politicians may want to forgot this saga, but NHS staff never will.”

Dr Alison George, a GP and member of the DAUK GP committee, said: “NHS staff have been totally excluded from the vaccination programme and the cost to purchase one privately ranges from £95 to £99.

“There is no clear explanation for such an irresponsible and short-sighted decision.

Long Covid

“Added to the physical effects on individual staff of acute and long Covid, it is likely to lead to increased staff sickness, cancellation of procedures and treatments and higher rates of nosocomial Covid.

“It is also worth considering the impact of the message this sends to staff and the public about the need for any mitigations against Covid.”

DAUK committee members are volunteers and campaign about issues facing doctors in their own time. Please support our work by joining DAUK or donating to our GoFundMe.

Professional responsibilities

At the lowest tier, GP receptionists, childcare staff, and teachers will provide ‘basic asthma awareness’ and signposting. GPs, resident doctors, and emergency department doctors are listed in tier three out of the five. They can ‘diagnose, assess, and manage acute and chronic asthma’ and ‘address factors that contribute to poor control’, the document states. At the higher levels of four and five, paediatricians with special interest, advanced nurse practitioners, tertiary paediatrician, and allied health professional (AHP) member of the asthma multidisciplinary team (MDT) are listed.

Replacing doctors

Dr Neena Jha, a member of DAUK’s GP committee and a GP in Hertfordshire, said the framework represented the direction of travel under the Government’s 10-year NHS plan. Posting on X, formerly Twitter, Dr Jha said the plan was ‘dismantling the practice of medicine’ and would ‘replace doctors with other HCP “to deliver task-based care”’. In a second post on X, she said: “In short, the Government’s 10 year NHS plan is to replace doctors with other HCP at scale.” Dr Alison George, who is also a member of the DAUK GP committee, said the document represented ‘taskification and tiered care in all its glory’ in a post on X.

Private healthcare

She added in a separate post on the social media website: “Private healthcare providers are circling with excitement. “Many are already embedded in the NHS, and Department of Health and NHS England’s doctor replacement policy opens up opportunities for more. “Very soon it will be impossible to guarantee doctor-led care unless you pay/have insurance.” The framework was initially highlighted on X by acute physician Dr Louella Vaughan. Dr Vaughan said: “Here is an example of what is coming.

Tasks and tiers

“The whole of medicine, broken down into tasks and tiers. “No need for knowledge. No need for expertise. “Brought to you by Health Education England.” DAUK is led by frontline doctors for frontline doctors. Please support our work by joining DAUK or donating to our GoFundMe.

DNA test

“You can die, potentially, at 10 with a ‘perfect DNA’ or you could live well into your old age without. “There are conditions where clearly knowledge is useful, but I am concerned about this concept of all babies being tested rather than an opt-in, targeted approach, which isn’t available at the moment anyway. “We haven’t got a targeted approach for those conditions with family history. That would make a massive difference.” Dr Taylor said consent was also an issue. “Knowing things about your life going forward is helpful,” he said.

Diagnosis

“But if you’ve been given a potential diagnosis of something that will kill you by the time you’re 20, do you want to know that so early?” He added: “There’s the area around paternity and grandpaternity. “You might suddenly find you’re not part of the family you thought you were.” Dr Taylor was commenting on a report in the Telegraph that within the next decade, every newborn baby will undergo whole genome sequencing. Health secretary Wes Streeting said it would move the NHS ‘from a service which diagnoses and treats ill health, to one that predicts and prevents it’.

Health anxiety

Dr Taylor said such a move would add to already increasing health anxiety. “Dealing with patients worrying about the future is one of the biggest things I deal with,” he said. “Patient anxiety, with increasing knowledge and data, is a huge problem. “It’s bad enough with smart watches, and things, let alone having a DNA profile.” Dr Sarah Jacques, DAUK GP committee member, posted her reaction on the social media platform X.

Genetic conditions

She said: “While there is a small cohort who will benefit from early diagnosis of rare genetic conditions where interventions are available. “There will be many who will feel they’ve been handed a death sentence when there is no clear course of action for them. “The benefits are nuanced.” Fellow GP committee member, Dr Alison George, also posted on X. Dr George said there were ‘significant issues surrounding consent’. She said patients would rather money was invested in ‘a properly functioning health service’. They would rather see a GP promptly, have A&E waiting times of one to two hours, and that doctors were not replaced by physician associates. Support our work by becoming a member or donating to our Go Fund Me.

Picture credit: Omar Lopez on Unsplash

Contract announcement

Dr George, a GP based in Newcastle, told ITV Lunchtime News it was ‘a positive announcement’. She said: “It will go some way towards repairing the damage that has been done to general practice over the past 14 or 15 years with the chronic underfunding and diktats from the Department of Health and NHS England. “There is still someway to go. overall I think it is a positive announcement. It means we have space to move things forward and bring general practice back from the brink.” Dr Lizzie Toberty, our GP lead, who is also based in Newcastle, was interviewed on national radio.

General practice

She told listeners to LBC’s Tom Swarbrick at Drive: “For many years, we’ve not seen an uplift in funding for general practice. “Despite increases in the cost of living, increases in the amount of funding needed to pay staff, there hasn’t been an increase in the funding provided. “And yet we’ve seen our population grow. “General practice as a whole has been struggling to provide what our patients have needed. “I think (the agreement) provides a glimmer of hope for GPs and patients alike. “It’s the first day a contract has been agreed between our union and the government over the last four years which shows that both sides are working together to make things better.”

Running costs

Visit our Instagram page to listen to Dr Toberty speaking on LBC. Dr Steve Taylor, our GP spokesperson and a GP based in Manchester, spoke to BBC Online Dr Taylor said he feared much of the extra money will go towards national insurance contributions, staff, and running costs. He said: “The new GP contract goes a small way to fix some of the significant issues for GP practices, in that it prevents further declines in funding with a small percentage increase.” Dr Taylor was also quoted in GP Online. He said: “’While there has been an acknowledgment of the need to invest in community services, a much larger investment will be needed to reverse the decline and build more capacity for the future. We look forward to seeing greater emphasis placed on GP provision in the future years.” GPC England announced on Friday it had voted to accept the proposed contract. It includes an overall funding uplift of £969m for 2025/26, contingent on full renegotiation of the national contract within this parliament. Read the full headlines. Please support our work by contributing to our crowd funder or by becoming a member.

Work with GPs

“Government needs to work with GPs urgently.” Dr Taylor highlighted an NHS England document in which an example of a reformed elective pathway for ear, nose, and throat (ENT) was cited. In the example, the patient, Sarah, is seen by a nurse practitioner, referred for a CT scan at a community diagnostic hub, before her results are discussed by the nurse practitioner and an ENT registrar. Dr Taylor said: “I’m pretty sure if Sarah had seen a GP she wouldn’t have needed to have a CT scan, no need to speak to the ENT registrar and, yes, it could be managed in the community “Why does NHS England always underestimate the skills of GPs?” DAUK GP committee member Dr Alison George added: “What a waste of time, money, and resources, and of course a patient having unnecessary ionising radiation.

Unemployed GPs

“Why won’t the Department for Health just fund the employment of approximately 3,500 under and unemployed GPs so they can offer the holistic, expert generalist care that patients so desperately need and is in fact extremely good value for money? “Remove physician associates from ARRS (additional roles reimbursement scheme). Put the funding back into the core budget. Allow practices to employ the GPs they want, so they can offer more patients the care they need and deserve.” Speaking on Times Radio, Dr Taylor welcomed the Government’s attempts to reduce waiting lists, but questioned the thinking behind some of the proposals. He said: “They’ve put forward a huge number of ideas, and you have to applaud them for coming up with some ideas. “Some of them are a very top down approach to finding solutions where they could have come up with more simple solutions. “Some of the things I’ve read make me wonder whether they’ve been written by somebody that’s got no idea of how to work in the NHS, certainly as a GP.

Patient choice

“One of the things they’ve suggested is patients should be given a choice of five different places they can go for their procedures, but if the waiting times for those places are long it doesn’t matter where they’re seen in Cornwall, London or Manchester. “Patients want their local hospital to be working for them.” And he questioned proposals to treat more patients in private clinics. He said: “If you spend more money using NHS budgets within the independent sector then clearly they can grow their margins. “They will grow from using NHS resources. “That’s the concern many people in the NHS have, they would love to see that money invested in the NHS in the first place.”

Lack of capacity

Dr Sarah Jacques, DAUK GP committee member, said the proposals looked like increasing the work and responsibility of primary care, ‘which lacks the capacity to deal with it all’. She said: “GPs will be able to order lots more highly-specialist tests that we won’t really know how to interpret, don’t have the capacity to follow up, don’t have the expert knowledge to action, and don’t have access to consequent procedures to treat patients. “People’s quality of care is not going to improve.” Dr Ellen Welch, DAUK vice chair, added: “The big question is who is going to staff these community diagnostic centres and surgical hubs and where are they taking them from to do so? “And who will analyse these tests? GPs, no doubt.

Staffing crisis

“We already have a staffing crisis in general practice, without adding even more to our workloads. “We need to see more of the detail, but on first look it looks like a massive dump onto general practice again.” Dr Lizzie Toberty, DAUK GP lead, said: “Funding is the crux of it all. We’ve seen general practice funding cut by a fifth but we’re being expected to do more and more – and now the proposals are for even more work to shift to primary care. “We’ve got thousands of GPs who are unemployed or underemployed. By funding general practice properly, those extra GPs can help keep people out of hospital and ease the strain on the rest of the NHS.” Please support our work by becoming a member or donating to our Go Fund Me. Read more about the Government’s plans.

GP employment

“And we remain very concerned about the implications of the ongoing employment of GPs through the additional role reimbursement scheme (ARRS). “We need more detail and are concerned this is nothing more than smoke and mirrors.” Dr Steve Taylor, DAUK GP spokesperson: “We cautiously welcome the extra funding, but it fails to address the fact that general practice has had a 20 per cent real terms cut in funding per patient over the past eight years. “GPs are now doing 20 per cent more work than before the pandemic – so we’re doing much more for much less and it needs addressing. “The additional role reimbursement scheme (ARRS) GP recruitment programme is failing to meet the needs of underemployed GPs, particularly those looking for the security of permanent jobs in practices. “Depending on reports, there have been between 60 to 300 GPs employed by the scheme to date at huge expense.

GP funding

“The money would be better spent if it was put into core GP funding.” Dr Alison George, DAUK GP committee member, said: “The concern is that the Department for Health is trying to employ more GPs through ARRS, effectively making them employed by the government on low pay and poor working conditions. “There are around 3,500 full-time equivalent GPs available to work now. Why would the government refuse to fund jobs for them but continue to fund approximately 2,000 physician associates (PAs) in general practice? “Funding GPs, who can give patients holistic care, is the best use of the ARRS funds for PAs and will keep more patients out of hospital. “The money needs to be put back into core budgets and let practices employ the GPs they need.” Dr Ellen Welch, DAUK vice chair and a GP, said: “We have repeatedly called for ARRS funding to be reallocated to restore core GP funding – and do so again.

Darzi review

“Lord Darzi’s review pointed out GPs are the most financially disciplined part of the NHS, and we have the unbelievable situation where thousands of GPs are unemployed or underemployed. “The billions of pounds being spent on inefficient ARRS that fragment care should be reallocated into core general practice. “We need to be able to use our budgets to meet the needs of our patients and communities, and to increase GP numbers for safer ratios of patients to doctors.” Dr Sarah Jacques, DAUK GP committee member, said: “It’s a very uncertain time for practices with many being forced to close or on the brink of closure.

National Insurance contributions

“This money will all be eroded unless the government fully reimburses GPs for the increased National Insurance contributions and we see an uplift in the DDRB (the Review Body on Doctors’ and Dentists’ Remuneration) recommendation for GPs’ rates of pay. “Without those we’re set for another year of defunding.” Support our work by becoming a member or donating to our Go Fund Me. Read more on Mr Streeting’s announcement.