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Independents' Day

Health chiefs ignore GPC demands over Tamiflu in care homes

Local GP leaders are once more urging GPs to decline requests for bulk prescriptions of Tamiflu for care home residents, after GPC demands for a contract to provide the service continued to be ignored.

Berkshire, Buckinghamshire and Oxfordshire LMC (BBOLMC) said that GPs are coming under renewed pressure to issue the bulk prescriptions to care homes experiencing outbreaks of flu, even though local health commissioners have still not set up a contract - as they would usually do for outbreak situations.

The issue has resurfaced despite repeated objections from the LMC and the GPC, who say GPs are not obliged to do the work as part of their core contract.

Dr Paul Roblin, chief executive at Berkshire, Buckinghamshire and Oxfordshire LMC, said in an email to practices: ’We are again seeing flu outbreaks in care homes, and Public Health England continue to contact practices asking them to prescribe Tamiflu to asymptomatic contacts of confirmed cases.

'BBOLMC and GPC believe this activity falls outside a GP's contract obligations.'

Dr Roblin added that although he had 'been in dialogue with NHS England for over two years'  it appeared that NHS chiefs 'have no intention of procuring an outbreak service', such as those for flu, iGAS, Hep A or other infectious diseases.

He urged GPs to follow his previous advice to forward any such requests from local public health officers to NHS England.

The GPC told Pulse it has written again to Public Health England to demand a solution and promised to ‘take further action’ if needed.

Dr Andrew Green, chair of the GPC clinical and prescribing subcommittee, said ‘the GPC has recently written to Public Health England expressing our concerns about the current holes in the system, and their expectation that GPs will act to plug these without being provided with the resources to do so’.

Dr Green added that the letter was sent ‘this month’ and that the GPC ‘will take further action depending on their response’.

The issue has been rumbling on since 2015, when it emerged that GPs had been bullied into prescribing bulk prescriptions at very short notice and without time to carry out necessary checks. This led to a 'significant untoward incident' being recorded at one care home.

GP academics also questioned the evidence for prophylactic use of antivirals in care homes in a public row with NICE experts, but both NICE and PHE stuck to their original advice.

The GPC subsequently issued national advice that GPs should refuse to issue the prescriptions, unless under a formal contractual agreement.


Readers' comments (5)

  • Have they still got stock to get rid of when the government bulk bought this stuff!

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  • Thought the evidence for Tamiflu was very poor so it is probably not going to change any outcomes

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  • Just Your Average Joe

    There are mountains of Tamiflu sitting going out of date - as they were useless with swine flu and still pretty pointless now.

    Side effects are significant, and it can't be administered blindly, renal function needs thought, and in a largely elderly population in care homes the side effects may be as bad as the flu.

    In those yet to get flu Tamiflu may be equivalent to actually becoming unwell and lead to admissions.

    The HPA send a fax asking for this to be done, so what do they actually do? They have staff sitting around doing not a lot in an office, so if they want to do this, they can take an afternoon trip out and arrange the meds from their stock pile and come out of the Ivory tower and go and do it themselves.

    Instead they tried to bully the practice into going out and wasting our time unpaid of course to then order FP10's for each patient individually,

    It would have taken a day to go through records and make sure safe and prescribe for each patient which I thought was pointless, and dangerous anyway.

    I politely told them to BOG OFF, and didn't do it. The flu has now passed and no harm to anyone, from the point they suggested giving, to the end where I didn't.

    Funniest part was I told CCG that this was a problem and one of the GPs there wrote back to say it was the practice's responsibility to do the public health role.

    They can BOG OFF as well!

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  • Just Your Average Joe

    I checked with local pharmacy and they had none in stock anyway (as it had no demand for this) and said it would take a few days to get the almost hundred doses required from accross their supply chains, which the HPA/CCG had no idea about either!

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  • Healthy Cynic

    I received 'instructions' from Public Health to prescribe Tamiflu 75mg bd to an asymptomatic elderly patient of mine. This was an inappropriate dose of a drug I have little faith in, and that commonly causes unpleasant side effects. Where is the governance if I give in and prescribe?

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