Safe healthcare for all individuals in a COVID-19 environment
In this new COVID-19 world, we have seen waves of restrictions impacting our movements and access to certain amenities, places and services. The release of the COVID-19 vaccine has seen many industries and individual businesses impose their own rules regarding access to their services based on the vaccination status of individuals.
AHPRA Guidelines for the facilitation of healthcare during COVID-19
In December 2021, the Australian Health Practitioner Regulation Agency (AHPRA) released guidelines for health practitioners regarding the facilitation of healthcare services to individuals in a COVID-19 environment. The guidelines reinforce existing codes and guidelines.
AHPRA has advised that individuals cannot be denied healthcare on the basis on their COVID-19 vaccination status. Additionally, healthcare cannot be denied if steps can be taken to keep individuals, the health practitioners and staff safe. It is acknowledged that there are certain circumstances in which an individual may pose a risk to the health and safety of health practitioners and their staff and others. In these circumstances, AHPRA has identified a non-exhaustive list of examples of safe access to healthcare for unvaccinated individuals. Such examples include:
- Consulting with the patient in a dedicated room or outside of the physical practice;
- Requiring the patient to wear a mask unless they have a valid medical exemption;
- Consulting with the patient at a dedicated time (for example unvaccinated people could be seen at the end of a consulting list to avoid potential cross-over with other patients);
- Asking patients to wait in a safe area outside until called in for their appointment (for example in their car);
- Asking patients to advise if they have had a recent negative COVID-19 test result prior to attendance at their appointment;
- Making arrangements to consult with a patient virtually or via telehealth if appropriate;
- Referring a patient to another health practitioner if safe access cannot be facilitated.
Health practitioners are required to firstly comply with the relevant public health orders within their jurisdiction. This is to be considered in conjunction with the principle of safely facilitating access to healthcare for all individuals.
Applicability to visitors and support persons
It is important to note that the above guidance would not apply to visitors (i.e. family members or support persons) accompanying patients seeking access to healthcare. The primary objective for health practitioners is facilitating safe environments for the provision of healthcare services. It is therefore possible that family members or support persons may be required to provide proof of their COVID-19 vaccination status and denied the ability to accompany the patient to their appointment if this poses a risk to the safety and wellbeing of the patient, the health practitioner and their staff, other patients and the safe provision of healthcare services.
The requirement for individuals to provide proof of their vaccination status is particularly important in healthcare settings due to the vulnerability of other patients and in order for health providers and practitioners to provide safe healthcare in the current COVID-19 environment. This can be contrasted to other industries such as hospitality and tourism where some businesses are choosing to monitor entry into their premises based on the vaccination status of individuals. This is presumably in an attempt to protect the employees and other patrons of those businesses, however, in the healthcare setting the primary driver is facilitating universal healthcare to all individuals. To do this, healthcare providers and practitioners legitimately require proof of vaccination to ensure that they are able to safely facilitate healthcare to those in need.
A Public Health Obligation
Health practitioners are reminded that they have a public health obligation and responsibility to promote the health of the community through evidence informed health education. AHPRA have noted that health practitioners play an important role in assisting the community in understanding the benefits of being vaccinated against COVID-19.
It is important for health practitioners to be aware that they are obliged to provide healthcare to all individuals regardless of their vaccination status, provided provision of their services can be performed in a safe environment.
The AHPRA guidelines are useful in assisting health practitioners consider alternate options for consultations and the provision of healthcare in circumstances where the patient is unvaccinated.
Above all, universal healthcare for all individuals is the take home message from these guidelines. In circumstances where there are no possible alternative solutions for the provision of safe healthcare in a COVID-19 environment, health practitioners should contact their relevant National Board for further guidance.