COVID-19: risk assessment for doctors

All doctors should have a risk assessment, including those returning to the NHS and existing staff. We cover risk factors, tools to help you and what the process should be.

Location: UK
Audience: All doctors
Last reviewed: 9 February 2022
COVID virus illustration

The BMA has called upon the NHS to introduce an effective system of risk assessment for all doctors, including those from a BAME (black, Asian or minority ethnic) background and ensure that doctors can work in a way that minimises risk to themselves and patients.

All doctors should have an individual risk assessment in their workplace. If you have not been given a risk assessment, or feel that you may be at risk based on any individual or environmental factors, you should raise this with your employer in the first instance. You can also contact the BMA for assistance.

Individual risk assessments for staff are separate to, and do not replace the need for, risk assessment of the workplace. This must take account of COVID-19 hazards and mitigation for them including the use of social distancing and PPE.

To empower doctors and GP partners to be appropriately risk assessed, the BMA has brought together resources that can help.

Risk assessment tool - December 2021

In light of the current situation with the omicron variant, we are reviewing our risk assessment tool, which was last reviewed in June 2021.

Tools to help understand the risks to you

Publisher Tool Purpose
The BMA Risk stratification tool To help facilitate your work-based risk assessment
Uses a scoring mechanism to help you quantify your biological risk
The Faculty of Occupational Medicine Risk reduction framework To inform safe working during COVID-19
To identify those within the workforce at greater risk, consider workplace hazards and deliver a more comprehensive individual risk assessment
NHS Employers Risk assessment materials Assessing doctors' risk which may support you and your employer
Resources for doctors to share with your line manager or practice

Risk factors

Risk assessments should be conducted on an individual basis and consider a range of factors that may put doctors and health care workers at greater risk from COVID-19, or have a greater impact of the disease.

Factors relevant to an assessment of COVID-19 risk include:

  • age
  • ethnicity
  • biological sex
  • disability
  • health conditions, and
  • pregnancy.

Current evidence for COVID-19 shows that those from a BAME background, those of Filipino birth and those who are older have been disproportionately affected by COVID-19, with specific underlying conditions increasing risk of severe illness. In addition, being male has also been associated with severe disease.

We have produced guidance on the increased risk to BAME doctors.


Doctors already identified as being at greater risk

A risk assessment should not replace the advice some doctors will have received, by letter or text message, explaining that they have already been determined as clinically vulnerable or clinically extremely vulnerable. A clinical evaluation of increased vulnerability should take precedence over any other risk assessment tools.

For doctors in these groups, working arrangements to mitigate their additional risk from COVID-19 should have already been implemented and should be maintained until they are informed otherwise.


What the risk assessment process will look like

Risk assessments should be done in a one-to-one setting, recognising this will require sensitive discussions. 

An individual health RA (risk assessment) for COVID-19 is an estimate of how likely you are to contract it in the type of work you do (workplace RA) and the likely medical consequences if this happens (personal health RA).

The workplace RA is the legal duty of the employer who controls the workplace. The employer is responsible for the ultimate decision on the work conditions and role in which an employee can be deployed, as they are likely to be held accountable if a worker contracts COVID-19 in their workplace.

Traffic light system

For a workplace risk assessment, work activities and work conditions are usually categorised into ‘traffic light’ risk category areas, according to the likelihood of exposure to COVID-19. If the employer does not have sufficient expertise to do this they should consult relevant experts eg in infection control and occupational medical and safety advice.

Who should carry out the assessment?

The individual health risk assessment can be completed on a self-assessment template, but where there is any doubt or concern, should be assessed through an OH (occupational health) department in medical confidence.

The employee takes the liability for filling it in accurately, as if they should come to harm due to inaccuracies, the employer is unlikely to be held responsible.

If there is a concern about the interpretation of the assessment guidance, the advice of an OH specialist should be sought to include a clinical judgement. This should preferably be provided by an accredited specialist occupational physician.

Assigning your risk category

The OH department will come to an individual health risk category for you, based on the current risk assessment guidance (this keeps changing). The OH department will advise you on your likely vulnerability if you were to contract COVID-19, with the rationale for reaching this view.

Your risk category will determine the traffic light risk area to which you can safely be deployed by the employer. The OH department will only pass their assessment of your risk category on to the employer with your written consent. However, please note that there may be a caveat to this issue.*

*The Secretary of State for Health and Social Care has issued NHS Digital with a notice under regulation 3(4) of the National Health Service (Control of Patient Information Regulations) 2002 (COPI) to require NHS Digital to share confidential patient information with organisations entitled to process this under COPI for COVID-19 purposes.

Disagreements about conclusions reached

Where there are disagreements about the conclusions reached between managers and staff, it may be necessary to raise these through local processes. You can contact the BMA for assistance.


After the risk assessment

If you are identified as being at high risk, your employer should take steps to mitigate the risk, as far as they are able.

These steps could include alternative clinical or non-clinical work where the risk of contracting COVID-19 is lower based on an environmental risk assessment and/or supporting remote working where possible.

You should not be asked to sign a waiver of risk by your employer. Your employer has a duty of care to their employees and must take measures to protect your health and safety while at work. If you are a GP partner and are concerned about the impact on your practice as a result of staff being removed from front-line patient care, your CCG should provide you with support to ensure you can continue to deliver services.

You can ask for an existing risk assessment to be repeated if you think there has been a significant recent change in your circumstances which might increase your risk of COVID-19. For example, a worsening of an underlying health condition or a change in the nature of the work that you are being asked to do.


The approach in primary and secondary care

Depending where you work, the approach to individual risk assessment will vary.

Primary care

If you are working in a GP practice, it may not be clear where responsibility for risk assessments lies and occupational health services are not available to all staff.

The BMA has long called for an occupational health service to be provided to all practices and their staff. The need for this service is now more crucial than ever and we have asked that it is established as a matter of priority to protect healthcare workers and to allow practices to continue to offer effective treatment and support to their patients.

If you are a GP partner or a single-handed GP, you may need to undertake a self-assessment.

GP employers have a legal obligation to carry out a risk assessment for their practices. We have produced guidance to support GP partners and practice managers with their risk assessment.


Secondary care and public health

If you are working in a hospital, it is generally your line manager who will carry out a risk assessment with input from an occupational health service where available. You may find undertaking a self-assessment of your risk first is helpful preparation for discussions you may have with a manager.

For doctors who work in multiple settings, you may require separate assessments.


Speaking out if you think you're at risk

The BMA’s view is that it is vital that healthcare workers are able to raise concerns about their safety and patients’ safety without fear of reprimands or even disciplinary action.

If you have not been given a risk assessment or feel that you may be at risk based on any individual or environmental factors, you should raise this with your employer in the first instance.


Risk assessment in Wales

As a result of our campaigning for improved protection for doctors during the pandemic, a new and consistent approach to COVID risk assessment in Wales has been published.

We would encourage you undertake a self-assessment and discuss the results with your employer or fellow partners immediately. It is the responsibility of employers to ensure a risk assessment is undertaken, the results recorded and actions taken to protect individuals.

If you are a GP partner and are concerned about the impact on your practice you should speak to your local health board.

We, in partnership with other health unions, have raised concerns about some of the scoring and threshold markers. We would encourage any member concerned about the process or outcome of the assessment to contact us.


Pregnant healthcare workers

In the UK, significant protections already exist for pregnant healthcare workers and these should continue to be followed in relation to COVID-19.

Considering the limited evidence available, pregnant women should only continue to work in patient facing roles up to 28 weeks gestation, provided a risk assessment has been undertaken and the working environment and/or individual duties can be modified.

The Royal College of Obstetricians and Gynaecologists (RCOG), Royal College of Midwives (RCM) and FOM have produced detailed guidelines.


Need help? For questions about any aspect of your working life, our advisers are here to help you. Opening times: 8am - 8pm Monday to Friday (excluding UK bank holidays) and 9am - 12pm on Saturdays.