Swine Flu: Authorisation of the supply of antivirals

Dear Colleague

SWINE FLU: Authorisation of the supply of antivirals

The purpose of this letter is to update you on how best to authorise the supply of antivirals from antiviral collection points safely.

Recently, senior representatives of the Royal College of General Practitioners (RCGP), the General Practitioners Committee of the BMA and Department of Health met to discuss the risks and benefits of GPs using normal FP10 prescription forms or specially printed vouchers to authorise the supply of antiviral medicines for swine flu. All agreed that a uniform, clear approach to the supply of antivirals should be sought. The discussion was underpinned by a safety assessment, a summary of which is set out below.

Children under 13 years old

In summary, vouchers must be used for all children under 13 because:

• the vouchers provide decision support on dosage in relation to weight and age
• the 15mg in 1ml solution for children under 1 can be easily selected (GP systems do not support the selection of this product. They only support the selection of the 12mg in 1ml suspension, and therefore could cause confusion at antiviral collection points)
• the antiviral collection point staff, who may not be pharmacists, are able to clearly identify which product to supply.

Patients 13 years and older

For all other patients i.e. 13 years and older, the safety case for use of vouchers was less clear, and the blank, “right hand side” of the normal FP10 prescription form should be used to authorise supply - unless GPs are not at their practice premises, in which case they should use the voucher.

When using the “right hand side” you should generate one as if you were issuing a private prescription. It is important to endorse it with the letters “ACP” so that Antiviral Collection Points are clear that this is an authorisation for the supply of an antiviral and not a private prescription. In any event, there should be no need to issue private prescriptions for influenza antivirals and doing so is strongly discouraged.

Use of the GP practice stamp on vouchers and recording

In all cases the name of the person ordering that antiviral should be written on the voucher and all vouchers must be signed and dated. However, if a GP practice has an up-to-date stamp with the practice’s address details, that may be used in the signature section of the voucher. You do not have to enter the PCT name or the practitioner PIN of the prescriber, even though the form may request this. The ordering of the antiviral should be recorded in the practice’s patient record and where possible in an auditable format.

Regulatory changes

Regulations set out the standard terms and conditions for General Medical Services (GMS) and personal medical services (PMS) contracts. These regulations are being changed to allow use of vouchers and FP10s for authorising distribution of antivirals via Antiviral Collection Points (ACPs) as described above.

We hope this information is helpful.

Best wishes

Steve Field, Laurence Buckman, Ian Dalton