Richmond house, 79 whitehall, london sw1a 2ns

From the Chief Medical Officer (Interim) Professor Dame Sally C Davies Gateway Reference Number: 15338
[email protected] Chief Pharmacists of Acute Trusts Pharmaceutical Advisers of PCTs Intensive Care Unit Directors Critical Care Directors
Dear Colleague
2010/11 SEASONAL INFLUENZA: PRESCRIPTION OF ANTIVIRALS
This letter contains information about the prescription of antivirals (oseltamivir and
zanamivir) to meet clinical circumstances arising during the current seasonal
influenza outbreak. Antiviral treatments for influenza are currently only available from GPs for NHS patients who are in a designated “at clinical risk” category. The most recent surveillance data indicate that higher than normal numbers of patients, who are not in one of the “at clinical risk” groups, are becoming seriously ill with flu – requiring hospitalisation. Regulations currently say that prescribers should not order oseltamivir and zanamivir for patients who are not in the target risk groups. However, the Chief Medical Officer has recommended that the current restrictions - see the Annex to this letter – should be amended to allow general practitioners (and other prescribers) to exercise their clinical discretion so that any patient who their GP feels is at serious risk of developing complications from influenza may receive these treatments on the NHS. This is consistent with guidance from NICE which informs the existing statutory restrictions but which envisages that prescribers may exercise their clinical discretion in individual cases. Urgent action is being taken to review the statutory provisions which affect the issue of prescriptions under the General Medical Services contract. In the meantime, PCTs From the Chief Medical Officer (Interim) Professor Dame Sally C Davies are advised to take no action to instigate enquiries into prescribing in these circumstances. PCTs are asked to deal with enquiries from prescribers on the basis of the information contained in this letter. Prescribers are reminded to endorse all prescriptions for flu treament with the reference “SLS”. Pharmacists can only dispense antivirals at NHS expense if this endorsement is made by the prescriber. Whilst antiviral manufacturers and wholesalers should have sufficient supply to meet demand, prescribers and pharmacists are asked to consider carefully the need to order sensibly and not to stockpile. Stockpiling and over-ordering could cause shortages. Further information about the contents of this letter can be obtained from Colin PROFESSOR DAME SALLY C DAVIES
CHIEF MEDICAL OFFICER (INTERIM)
From the Chief Medical Officer (Interim) Professor Dame Sally C Davies
ANNEX – groups eligible for NHS prescriptions for influenza treatment
has asthma that requires continuous or repeated use of inhaled or systematic steroids or with previous exacerbations requiring hospital The statutory restrictions subject to amendment are set out in schedule 2 to the National Health Service (General Medical Services Contracts)(Prescription of Drugs etc) Regulations 2004. These are reproduced in Part XVIIIB of the Drug Tariff.

Source: http://pegasus.openrome.org/uploads/notes_techniques/9ff19975a1a8cd30c7bf0804954ba3a022b54c6a.pdf