GPs are seeing an increase in demand for appointments from parents concerned their children have a strep A infection, with doctors describing the situation as “unrelenting”.
On Monday, Pulse reported that doctors they have been advised to “have a low threshold” for prescribing antibiotics for children presenting with symptoms.
But the BMA said GP services should not become too overwhelmed to care for other sick patients, and urged England’s NHS to urgently add additional capacity to NHS 111 call handling services.
Meanwhile, pharmaceutical organizations have reported shortages of liquid antibiotics commonly prescribed to children.
According to reports from The Independent, NHS 111 services are also overwhelmed with demand.
Dr Kieran Sharrock, acting chair of CPG England at BMA, told Pulse: “We fully understand the concerns of parents and guardians over the latest outbreak of Strep A, however it is important to remember that severe cases of the infection are incredibly rare and most children will recover, at home, without any clinical intervention.
“GPs are seeing an increase in demand for Strep A, but what must not happen is that general practice is overwhelmed. We are already working at maximum capacity, with very few doctors, and we must ensure that we remain available for other patients who need us.’
He said that to help GPs, NHS England “must ensure that concerned patients are initially flagged to contact NHS 111, so that they are given the right advice or directed to the most appropriate service if necessary, while allowing GP practices to continue to provide care.” to those patients who need them most’.
Therefore NHS England must urgently order additional capacity at NHS 111 as well,’ he added.
“This means better-trained phone operators and appointment times to ensure sick children who need a GP assessment are identified and booked to be assessed by their practice as soon as possible.”
Speaking to Pulse, Dr Osman Bhatti, a GP in east London, said: “We started to see the increase on Friday (December 2). Patients are being triaged and assessed online and by phone, but we are bringing in more patients, so we have to make sure we don’t mix patients coming into the practice with infectious diseases.’
Dr Bhatti described the situation as “unrelenting” adding that one of the doctors was still processing patients at 9pm.
“We had a practice meeting to discuss and work closely with the team to meet the demand and ensure that everyone is involved, not just clinical staff but also support staff,” Bhatti explained.
Dr Sanjoy Kumar, a GP in east London, said he has noticed an increase in antibiotic cases and is concerned that increased demand could lead to antibiotic shortages.
He explained: ‘In our area, we have had an increase in cases and use of antibiotics and our fear if additional resources in terms of clinic start-up and the model similar to the Covid hot clinics should be thought of. by the bodies in charge of giving a hand to Primary Care. We advise that supply chains are being strengthened”.
Dr Bhatti said his practice is prescribing more antibiotics than normal, however they have protocols in place.
He said: “There are protocols for the issuance of antibiotics, so we can modify management to liquid or crushed tablets or alternative antibiotics.”
Dervis Gurol, pharmaceutical superintendent at HealthyU Pharmacy in Saltdean, East Sussex, echoed Dr Kumar’s concerns.
He said: ‘There’s a real fight right now to get first-line or second-line liquid antibiotics. If we are lucky enough to find one, some of the wholesalers charge exorbitant prices. For example, one of the wholesalers was charging around £1 for an item or medicine. Yesterday they were asking for £5.99 but the NHS will only refund us the price of the £1.29 fee.
“We have been taking the hit for several months. We are subsidizing the NHS drug bill because price concessions are not working,” added Mr Gurol.
Speaking to Pulse, Mr. Gurol described how a nine-year-old patient collapsed yesterday in the pharmacy and was admitted to hospital. He explained that the family had visited several pharmacies looking for Strep A antibiotics.
“This is having a big impact on patients, especially the little ones,” he added.
The Association of Multiple Independent Pharmacies is seeing an increase in the number of prescriptions for penicillin and amoxicillin. According to CEO Dr. Leyla Hannbeck, the supply of these oral liquid medicines (used for children) from wholesalers is “spotty” and “pharmacies are experiencing supply problems from ALL wholesalers.”
Dr. Hannbeck confirmed that there are supply problems with other antibiotics as well.
She said: “We are concerned that if the government and DHSC do not put effective plans in place, we will run out of these medicines quickly.”
The Association could not say how long the shortage would last as supply follows demand. They are advising pharmacies to work closely with GP practices to ensure GPs are aware of the situation and asking them to share any relevant information they may have with pharmacies so they can help better handle this situation.
Increase in cases of strep A
UK public health officials have issued the low threshold advice for antibiotics in primary care, emergency and pediatric services amid concerns over high levels of infections and the deaths of seven children since September.
GP visits for scarlet fever and disease notifications are rising more than expected for this time of year, as are cases of invasive group A strep, albeit less pronounced, the UK Health Security Agency has warned. .
A total of 4,622 notifications of scarlet fever were received from week 37 to 46 of this season (2022 to 2023) in England, with 851 notifications received in week 46 compared to an average of 1,294 (range 258 to 2,008) for this season. same period (weeks 37 to 46) in the previous five years, UKHSA figures show.
There is considerable variation in England with the highest rates observed in the North West.
Laboratory notifications of invasive group A strep disease are also higher than seen in the last five years with 509 compared to 248. The highest rates to date have been reported in Yorkshire and Humberside.
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