Paracetamol- Information from CCG Medicines Optimisation Team
There is a shortage of paracetamol 500mg formulations in Primary Care with all pack sizes and formulations (tablets, caplets and capsules) being affected which includes:
- General Sales List - Pack size 16 or smaller
- Pharmacy only - Pack size 32
- Prescription Only Medicine - Pack size 100
Some manufacturers have reported that they are still currently supplying wholesalers for pharmacies to restock. However due to some stock piling by patients purchasing OTC and GSL medications and restrictions on export from India and China, current supply is limited.
Patient who self-care with paracetamol
Providing a prescription of paracetamol, to patients who usually purchase their own products is not recommended as this is likely to rapidly deplete remaining stocks of POM packs of paracetamol.
Patients should be advised to try several suppliers locally in order to purchase their formulation of paracetamol. It would be advisable for patients to phone in advance, to ensure that stocks are available to purchase. GSL packs of paracetamol (16s) are also available to be purchased from petrol stations, retailers and supermarkets, as well as Community Pharmacies. Patients should be advised to purchase only the quantity of medication that is required and not to stockpile large quantities of medication as this may precipitate further supply issues with these products.
Patients who usually receive their supply of paracetamol on prescription
Where a patient has been receiving their supply of paracetamol on prescription (patient is unable or unwilling to self-care), a sufficient supply should be prescribed, as is necessary, for the individual patient based on their current needs.
We would advise that you liaise with your community pharmacies and dispensaries directly to ascertain their local stock holding of the POM packs of paracetamol 500mg to ensure that all patients who clinical need paracetamol can continue to receive a supply at this time.
Patients who are prescribed a multiple of 100 paracetamol 500mg tablets routinely due to the pack size, but require less than this to meet their clinical needs, should have their prescription quantity amended.
Current advice on the use of ibuprofen as an alternative
Ibuprofen formulations share similar licensed indications to paracetamol. However, there has been concern about the use of non-steroidal anti-inflammatory medications (NSAIDs) in relation to Covid-19 following a statement by the French Health Minister (a clinician) advising against the use of ibuprofen.
Infant Paracetamol and fever following Vaccinations
We are aware of some reports of parents facing difficulty in obtaining paracetamol; Whilst parents should continue to try to obtain and administer infant paracetamol if possible, infant vaccines can and should still be given even if it is not possible to give prophylactic paracetamol.
Parents who have been unable to obtain infant paracetamol should be advised as follows:
- Fever can be expected after any vaccination but is more common when the MenB vaccine (Bexsero) is given with the other routine vaccines at eight and sixteen weeks.
- In infants who do develop a fever after vaccination, the fever tends to peak around six hours after vaccination and is nearly always gone completely within two days.
- Ibuprofen can be used to treat a fever and other post-vaccination reactions. Prophylactic ibuprofen at the time of vaccination is not effective.
- Information about treating a fever in children is available from the NHS UK webpage “Fever in children” at www.nhs.uk/conditions/fever-in-children/
- If an infant still has a fever 48 hours after vaccination or if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111.
- The diseases that the vaccines protect against are very serious and therefore vaccination should not be delayed because of concerns about post-vaccination fever.
We have also been made aware of concerns that parents will not know whether a fever in their infant following immunisation is due to their immunisations or to COVID-19. Indications to date suggest that COVID-19 causes mild disease in infants and children. As has always been recommended, any infant with fever after vaccination should be monitored and if parents are concerned about their infant’s health at any time, they should seek advice from their GP or NHS 111.
The same advice applies to teenagers who are due their routine adolescent immunisations. Teenagers are less likely to develop vaccine reactions such as fever and if they do, these are generally short lived and resolve quickly. COVID-19 is associated with a more prolonged course of illness with respiratory symptoms, especially cough, which would not be expected following vaccination. As with the infant primary immunisations, PHE are recommending that the routine adolescent immunisations should not be delayed.
Coming SOON! - DoctorLink
We invite you to click on the link below - at the moment we are not yet live as staff are still being trained.
Removal of Surgery Fax Machines
The NHS guidelines state that the use of fax machines will no longer be permitted in a bid to improve patient safety and cyber security. As a result, we will no longer be using our fax machine for incoming and outgoing correspondence as of March 31st, 2020.
This should not cause any changes to patient contact or care but it will mean that we will no longer be able to fax documents to any other NHS organisation or receive faxes from outside organisations, including prescription services such as Well, Boots etc. These companies will be contacted in advance and advised to encourage patients to use accepted online methods such as System1 Online Access or the NHS app
Guide to NHS Services Outside of GP Opening Times
Local residents are being urged to use NHS services wisely and ensure they choose the right service for their illness or injury.
NHS 111 can help residents if they need medical help or advice urgently but it’s not a life-threatening situation. Open 24/7, 365 days a year, NHS 111 connects patients to a team of fully trained call advisers who are supported by experienced nurses, paramedics, and GPs.
They will ask questions to assess the symptoms, and give healthcare advice or direct the caller to a local NHS service. If necessary, they can also call an ambulance or direct people straight to A&E. Calls to NHS 111 are free from a landline or mobile phone.
- GP out-of-hours service (OOH)
You can access the GP out-of-hours service by calling NHS 111. The NHS 111 team will assess your condition over the phone and if they think you need to be seen by a health professional, they will refer you to the OOH GP service.
Many minor illnesses can be treated at home with basic medicines that are available from your local pharmacy. Stocking up on essential medicines can help you avoid a trip to the GP or even A&E. Medicine cabinet essentials include:
- painkillers such as aspirin, paracetamol, and ibuprofen
- anti-diarrhoea tablets and rehydration powders
- indigestion treatment
- bandages and plasters
- antiseptic cream or spray
- first aid kit
Local pharmacies can offer expert advice and treatment for a wide range of common conditions and minor injuries.
Pharmacies can help with a range of things including aches and pains, hangovers, colds, emergency contraception, and non-prescription medication.
- Mental Health – 111 option 2
There is a First Response Service (FRS) in Cambridgeshire and Peterborough which gives those in mental health crisis the opportunity to get access to help quickly, by calling NHS 111 and selecting option 2*.
The new service allows patients or carers to speak to specially-trained mental health staff who can provide advice, support, and signposting to other services. The service is available 24/7, 365 days a year. Click HERE for further information. Calls to NHS 111 are free from a landline or mobile phone.
*Patients registered with practices in Wisbech can access the service via dialling 111. The call handler will then transfer them direct to the FRS service.
- Dental emergency and out-of-hours care
If you think you need urgent care, contact your usual dentist as some practices offer emergency dental slots and will provide care if clinically necessary. You can also call NHS 111, who can put you in touch with an urgent dental service.
Who can have a free shingles vaccination?
You are eligible for the shingles vaccine if you are aged 70 or 78 years old. When eligible, you can have the shingles vaccination at any time of year.
In addition, anyone who was previously eligible for immunisation (born on or after 2 September 1942) but missed out on their shingles vaccination at any time of year.
- The shingles vaccination is not available on the NHS to anyone aged 80 or over because it seems to be less effective in this age group.
This is a one off vaccination and reduces the chances of developing shingles, and even if you do develop shingles then the disease is likely to affect you less severely.
Shingles is caused by the reactivation of the chickenpox virus and lies dormat after infection as a child. Later in life it can reactivate and cause shingles. why this happens is not completley known, but reaching an older age makes the virus much more likely to reactivate. Shingles and its complications can be difficult to manage. The treatment options vary from person to person depending on the area affected by the shingles. It is important to see your GP as soon as possible after the rash occurs, as some treatments work best when given early. Shingles can not be caught from someone with chickenpox, however, it is possible to catch chickenpox from someone with shingles.