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.