Tamiflu Prophylaxis in Care Homes

Date sent: Monday 21 September 2015

All TV Practice Contacts - please circulate within your pratcice as apporpriate

Issue date: 21.09.15

Could practices please note that I have had no replies from PHE on the “Tamiflu Prophylaxis in Care Homes” issue since I last wrote to you in June.

As the Flu immunisation season is almost upon us and this was major issue last year, I thought it sensible to remind you of BBOLMC and GPC advice.

Please see the box below;


The position of LMC and GPC remains the same as last winter

GPs have no contractual responsibility to treat the well contacts of a case of flu

The evidence base for Tamiflu in these circumstances is weak

No patient should be given a drug without giving informed consent through a consultation

The workload involved in doing this often late in the day can be vast

If PHE and NHSE have agreed a relationship that “PHE advises and NHSE implements” then it is up to NHSE to commission a provider for the work.
My view is that GP practices are unlikely to be in a position to respond in such circumstances

In commissioning a provider, NHSE will have to assess the importance and urgency of the task

Should PHE staff contact you during the next flu season (insisting you treat well contacts in care homes with Tamiflu) I suggest you ask them to contact the Medical Director of NHSE directly to see what arrangements have been made

Care of patients with flu like illness is a GP’s responsibility, and my advice is to use your judgement on the efficacy and cost of Tamiflu in deciding what therapy is appropriate.
I will update you as and when the evidence base changes


Last year there were also issues with PHE staff phoning practices to persuade them to undertake contact tracing and contact management for other infectious diseases (Hep A and PVL Staph aureus).

My view is that this is not a GP task so requests from PHE should be declined with the suggestion that PHE should contact their local NHSE Medical Director to see what has been commissioned for these purposes.


Dr Paul Roblin


Tel: 07799116597 or 01628 475727






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