The CQC has fully revised and reissued this information to incorporate up-to-date resources and advice – here’s what practice managers need to know
CREDIT: This is an edited version of an article that originally appeared on the CQC
Travel health services are available from a range of NHS and independent healthcare services. These include:
NHS GP practices
private travel clinics
some specialist clinics providing post-tropical screening services
occupational health settings
military healthcare settings
pharmacies
independent schools and universities.
In England, a provider needs to be registered with CQC if it provides travel health services that are delivered by a doctor or a nurse. This comes under the regulated activity of treatment of disease, disorder or injury.
Travel health services are exempt from CQC registration if they are provided in:
occupational or military settings – these work under their own standards of practice
pharmacies – where the service is not delivered by a doctor or nurse.
NHS GP practices are required to offer certain vaccinations for the purposes of travel, free of charge. The travel vaccines available on the NHS are provided because they protect against the diseases thought to be the greatest risk to public health, if brought into this country. These are:
polio (given as a combined diphtheria/tetanus/polio jab).
Governance structures and individual travel medicine practitioners influence the quality and safety of services. In NHS general practice, this duty of care is often delegated to general practice nurses (GPNs), pharmacists and paramedics.
The GP delegating must be satisfied that the person providing care has:
the appropriate qualifications, skills and experience to provide safe care for the patient
access to appropriate training, supervision and oversight.
Registered nurses delivering travel health services are professionally accountable to the Nursing and Midwifery Council (NMC). They work within the NMC Code (2015).
Training
Regardless of their profession, the minimum standard of practice for practitioners who deliver travel health services is the same. Pre-travel consultations are complex. Practitioners need a wide knowledge that covers:
geography and epidemiology of infectious disease
vaccine-preventable diseases
infections transmitted by insect bites
non-vaccine preventable risks
the ability to risk assess and communicate this to the traveller.
Initial training for travel health should be in line with:
There should be evidence of formal training in immunisation and ongoing evidence of competence. Practitioners should also achieve safeguarding competence at the appropriate level. This includes awareness of female genital mutilation and forced marriage. See the RCN Travel Health Subject Guide.
Practitioners administering yellow fever vaccines must meet the standard required to register as a Yellow Fever Vaccination Centre. This is administered by the National Travel Health Network and Centre.
When the CQC inspect:
We may not look at every regulation at every assessment. Where we identify concerns regarding travel services, we assess against:
opportunities for continuing professional development
complaints and significant event arrangements.
We expect to see processes to assess, monitor and mitigate the risks relating to the health, safety and welfare of patients. Examples include:
Using a recognised online tool to identify country-specific risks to help make recommendations. Country-specific risks include vaccine-preventable and mosquito-borne diseases. See the travelhealthpro website
A comprehensive travel health risk assessment completed for each person using the service.
Clear documentation of the risk assessment for:
all vaccines given
medicine prescribed or advised
vaccines declined.
Risk assessment of the emergency equipment and medicines required. As a minimum, this must include adrenaline.
Working within the relevant legal framework for the administration of medicines. This includes:
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