The GPC still has not received any response from public health chiefs more than three months after they called for a meeting to address concerns about preventive Tamiflu prescribing in care homes, it has emerged.
GP leaders wrote to Public Health England on 4 February, raising concerns about ‘inappropriate pressure from PHE to prescribe Tamiflu for the prophylaxis of influenza in nursing and care homes where there have been confirmed cases of influenza’.
But the GPC told delegates at the LMCs Conference that they had still not heard back from Professor Paul Cosford, PHE director of health protection, almost four months after sending the letter.
The revelation came as the LMCs Conference agreed the ‘use of antivirals demanded by Public Health England has weak evidence and is not part of the core general medical services’.
Dr Andrew Green, chair of the GPC’s clinical and prescribing subcommittee, said the GPC would use the conference’s backing to go back to PHE and ‘hit them harder’ over the issue,
The letter was sent after Pulse revealed GPs in some areas reported being bullied by local PHE officials into providing mass Tamiflu prescriptions at short noticewith one care home reporting a significant untoward incident as a result.
The letter called for a meeting with PHE to discuss setting up a dedicated enhanced service to cover the additional workload – and said that until the work was resourced the GPC was advising GP practices not to undertake the work.
But Dr Green said: ‘We did write to Professor Paul Cosford of Public Health England with these issues back in February – we are now in May and we have had no reply at all… This will now mean we will go back to him and hit him harder.’
The motion at the LMCs Conference was put on behalf of Somerset LMC by Dr Nick Bray, who stressed PHE’s directive to prescribe antivirals to all patients in care homes with a flu outbreak within 48 hours was ‘certainly not’ part of GP core work.
Dr Bray said: ‘Preventative prescribing is certainly not core work. All preventative activity – such as health checks, cervical cytology and vaccinations including flu jabs are additional or enhanced services – properly resourced so they can be properly delivered. Yet for some reason [PHE] seems to consider that GPs providing preventative oral antiviral antimedication is core work.’
Dr Bray added: ‘Public health needs to understand GPs cannot pick up work like this without proper resource and support.’
Speaking to Pulse, Dr Green said: ‘We will now take this motion back to them and try to get clarity because we don’t believe that it is part of essential or aditional services.
‘There should be a proper funding stream in place that not only rewards doctors for doing it but also makes sure they are doing it safely without jeopardising their patients. The issue is this is a huge amount of work that comes at very short notice and what you don’t want to do is be diverted for the entire day and neglect your other patients.’
In a statement issed by PHE, Professor Cosford said: ‘NHS England are the principle point of negotiation for the provision of clinical services, but Public Health England are always happy to discuss the evidence with the GPC or any other relevant organisation.’