Antiviral supply (Flu outbreaks and pandemic)

Published on: 2nd March 2020 | Updated on: 15th March 2022

Pharmacies may supply antivirals for the treatment of flu on NHS prescriptions, during the times when the Chief Medical Officer and Chief Pharmaceutical Officer have advised that seasonal influenza is circulating. Outside of that period, general practitioners are unable to prescribe antivirals under the General Medical Services regulations and alternative local commissioning arrangements need to be made.

Localised community outbreaks of influenza in the out of season period

To fulfil the need to respond to localised outbreaks in the out-of-season period, NHS Clinical Commissioners and its members worked with NHS England and NHS Improvement (NHSE&I) to develop an approach whereby Clinical Commissioning Groups (CCGs) will commission appropriate primary care clinicians to respond to these outbreaks, by assessing exposed persons for the antiviral treatment or prophylaxis and completing a patient specific direction or issuing a private prescription for this purpose.

Localised community outbreaks of influenza in the out of season period: Letters to clinical commissioning groups (NHSE&I)

Localised community outbreaks of influenza in the out of season period – template procedure (NHSE&I)

Localised community outbreaks of influenza in the out of season period – frequently asked questions (NHSE&I)

In some cases, supplies of the antiviral may be made from local PHE antiviral stocks (with the CCG funding replacement stock) or from hospital pharmacies. An alternative approach adopted by some CCGs, is to commission several community pharmacies to hold stock of the antivirals and to issue them against private prescriptions (pharmacies can’t make a supply against a patient specific direction) written by the primary care clinicians commissioned to respond to the local outbreaks.

Community Pharmacy England holds details of some of these services on its services database.

Supply of antivirals during a flu pandemic

During the 2009 flu pandemic, some community pharmacies supplied antivirals as part of locally commissioned arrangements and as part of the system that supports the National Pandemic Flu Service (NPFS).

The NPFS is designed to supplement the response provided by primary care if the pressures during a flu pandemic mean that it is no longer practical for all those with symptoms to be individually assessed by a doctor or other health care professionals in order to access antiviral medicines.

The NPFS comprises an online and telephony self-assessment service where individuals are not assessed by a clinician but follow a process of answering questions which have been developed with extensive advice from clinicians, which determine whether the person who is ill is eligible for an antiviral medicine or not. Individuals may also be directed to other health interventions such as self-care advice at home or referral to the emergency services for an ambulance response.

Community Pharmacy England and NHSE&I have agreed an Enhanced service specification for pharmacies acting as antiviral collection points (ACP), which will be used to commission community pharmacies to supply antivirals, from the national Public Health England stockpile, to patients that have had a supply authorised by the NPFS. At the point that a flu pandemic is likely, Community Pharmacy England and NHSE&I will agree funding for provision of the service and the service specification will be released for use by regional NHSE&I teams.

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