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Category: Clinical Issues



BMA Coronavirus Update (18 Feb 20)

Please find below a link to the latest document from BMA for the Coronavirus. Click Here

Coronavirus Webpage

Dear GPC UK,

The BMA has now published a web page<> highlighting key information and links to official guidance from government agencies on Coronavirus, including how to handle queries from patients and how to manage patients who contact or attend GP practices.

We are in regular dialogue with key health agencies across the UK and are monitoring the situation in order to support preparedness. We are listening to what GPs are telling us and your feedback on preparedness and the robustness of information provided nationally and locally will be relayed back on behalf of the Association. We are working with the BMA emergency preparedness lead, Dr Peter Holden to ensure that we maintain links to the latest official Government guidance.

We are aware that GP practices in England are being contacted by their CCGs, on behalf of NHS England and Improvement (NHSEI), requesting information regarding practice preparation for Coronavirus. Our advice remains that while there is no obligation to provide this information, unless the Secretary of State issues a direction, we would encourage practices to respond so that NHSEI and Public Health England are aware the national picture for preparations.

In addition we remain in close contact with NHSEI to ensure that any measures they put in place are supportive and do not place any overly onerous or punitive burden on GPs and the patients they support.

As well as using this information you should continue to review your practice business continuity plans, infection prevention and control measures and other relevant guidance in addition to any national guidance issued by relevant UK health or public health agencies.

Stuart Abrahams
Deputy Head of Committee Secretariat
General Practice
Policy Directorate

A Visual Guide to Vaccinations

Please see the link on the Government website. 


Flu vaccine ordering for 2019/20 season

Practices should place their orders as soon as possible (given the issues we had this season), to avoid any delay in delivery of vaccines and to ensure you have supplies of the recommended vaccines in September, ready for the start of the season for all your eligible population.  We have been assured that there will be no phased delivery for next season and a practice can choose to have their order delivered in one batch at the start of the season or split into two deliveries, depending on available fridge space.  Most pharmaceutical companies offer a sale or return service on a percentage of their order, so there is scope to return unused vaccine to the supplier.

Vaccines recommended are as follows:

  • The standard egg cultured quadrivalent inactivated vaccine (QIVe) will continue to be recommended for 18 to 64-year olds in clinical at-risk groups and other eligible groups, including frontline health and social care workers.
  • The adjuvanted trivalent inactivated vaccine (aTIV) will continue to be recommended for individuals aged 65 years and over.
  • In addition, the cell grown quadrivalent vaccine (QIVc), Flucelvax® Tetra, is now licensed for use in the UK for patients aged nine years and upwards and is suitable for those aged 9 to 64 years in clinical at-risk groups, frontline health and social care workers and for individuals aged 65 years and over.

Note that all children's vaccines will be centrally procured, as in previous seasons, and can be ordered from ImmForm.

Gabapentin and Pregabalin to be reclassified as Controlled Drugs

From 00:01 on 1 April 2019, gabapentin and pregabalin will be reclassified as Schedule 3 controlled drugs.  Full details were emailed to practice managers on 13 February.  This is an alert to those who have not yet been informed of the change.  When prescribing for Schedule 3 controlled drugs note particularly that:

  • The dose must be clearly defined ('as directed' is not acceptable.)
  • DHSC recommends that the maximum quantity should not exceed 30 days' supply.
  • Emergency supply is not permitted.
  • There must be a valid controlled drug prescription to obtain supplies from a pharmacy. 
  • From 1 April 2019, it will be not be possible to supply pregabalin and gabapentin through repeat dispensing, e.g. paper FP10 RD form or electronic repeat dispensing (eRD). This means prescribers must not issue repeatable prescriptions. (This is distinct from issuing a repeat prescription, to be requested and issued by the practice, with a wet signature attached.) Suppliers of EPS systems will update their systems by 31 March 2019 to support the change to the classification of gabapentin and pregabalin. Although system suppliers will make these changes prior to 1 April 2019, gabapentin and pregabalin prescriptions should not be treated as Schedule 3 controlled drugs until 1 April 2019.

You should now:

  • Ensure your practice team is aware of the change.
  • Stop repeat dispensing for gabapentin and pregabalin as early as possible before 1 April 2019 and put transition arrangements in place for patients.  
  • Inform all patients currently taking pregabalin and gabapentin about the impact this change will have on their prescriptions. Ask them to ensure they request any prescriptions in plenty of time, to help the NHS to manage the transition process.

It is not helpful or appropriate for anyone to stockpile these medicines. 

Flu vaccines for 2019/2020

As already circulated by email, the definitive list of flu vaccines for this coming season can be seen here.  Please note that Public Health England will continue to procure and supply all LAIV and injected flu vaccines for those aged under 18 years. These vaccines are to be ordered through Immform:

Seqirus plan to have a 'soft close' on ordering of adjuvanted trivalent influenza vaccines (aTIV/Fluad recommended for patients aged over 65 years) at the end of February. They are allocating delivery slots and the current 'week available' (as of 22.01.19) is the 23.09.2019.  Seqirus have confirmed that the aTIV vaccines will be delivered with staked needles.

Flu vaccination for pregnant women

Proportionately the risk of dying from flu is far greater for pregnant women than for other cohorts.  The LMC and LPC are equally concerned that the uptake of vaccination is still too low in this group.  From our side, please do everything you can to liaise with your local midwives to ensure that this group are all protected.  It should not matter who gives the vaccination, but whoever is best placed to do it should do it while they have the woman in front of them.




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