Following concerns raised in January about inappropriate pressure from Public Health England (PHE) to prescribe Tamiflu for the prophylaxis of influenza in nursing and care homes where there have been confirmed cases of influenza, we took legal advice on this issue which we highlighted in a letter to PHE, and which is pasted below for information.
GMS regulations are clear that this service is not included under essential services that practices are required to provide for their registered patients. Essential Services are defined in the GMS regulations with reference to regulations 15(3) (5) (6) and (8). Additional work must be commissioned and funded separately as an Enhanced service. Examples of these are the influenza vaccination programme and catch up MMR vaccination campaign.
Although PHE disagreed with this view, we would like to re-iterate the GPC’s advice to practices that this work is not covered by their contracts and that if requested, practices should advise PHE [or whoever else who requests this] that unless this service is properly commissioned, they will not be providing it in the event of a flu outbreak. We have informed the Chief Medical Officer that we would advise practices as such. We would also advise LMCs to contact their CCGs to alert them to this gap in provision and invite them to commission a service.
Catharina Öhman, Senior Policy Executive (Clinical and Prescribing, QOF, GPDF), NHS Primary Care Division, Policy Directorate, British Medical Association
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