Doctors defy flu drug order

Relenza may be able to shorten flu attacks

Many patients may still not be able to get Relenza this winter as doctors disobey government guidance on the drug.

The National Institute for Clinical Excellence (Nice) performed a U-turn last month and recommended that Relenza should be made available to certain high-risk patients during flu outbreaks.

This is a problem that is going to happen elsewhere

NHS Alliance spokesman

However, one group of doctors has already voted to defy the guidance and refuse patients Relenza on the grounds that it is too expensive.

And the organisation that represents most of the primary care groups in England and Wales predicts that many more will choose this course of action.

Nice has no actual powers to force doctors to prescribe the drugs it recommends, but the Department of Health is warning that those family doctors who do not toe the line could be in trouble.

The GP's newspaper "Doctor" reported on Thursday how the Mid-Devon Doctors' Group which represents 20 practices in the area, had voted overwhelmingly not to prescribe Relenza.

The group covers towns such as Okehampton, Tiverton and Crediton.

Dr Charles Kent, its chairman, said: "It's a drug we're not familiar with. I'm not prepared to prescribe a drug to my patients that I wouldn't take myself."

However, Nice's chairman, Professor Sir Michael Rawlins, said: "I would just like to remind them that a group of highly expert individuals have looked at this, which includes GPs."

"Just how will they feel when one of two patients in the primary care group dies of flu?"

While the vote does not automatically mean that the local primary care group will outlaw Relenza prescriptions, it is likely to mean that many patients going to their doctors in Mid-Devon asking for Relenza will be turned away.

The NHS Alliance, which represents primary care groups and trusts, says that many more are likely to leave it to individual doctors to decide whether Relenza prescriptions can be justified.

A spokesman said that, as extra money had not been made available to cover the £25 a course cost of the drug, many practices were reluctant to take money away from other services to pay for Relenza.

They are potentially letting themselves in for a bit of trouble if they don't follow them

Department of Health spokesman

She said: "This is a problem that is going to happen elsewhere.

"Nice has been hyped as something which could stop postcode prescribing but it can't."

She added: "If doctors are prescribing Relenza, they will have to make cuts elsewhere."

Two bodies which provide legal assistance for doctors facing negligence claims, the Medical Defence Union and Medical Protection Society, have both warned doctors to be careful when choosing to disregard the advice of Nice, and to record their reasons in the patient's notes in case of legal action.

A spokesman for the Department of Health said: "The uptake of Nice guidance will be monitored by the Commission for Health Improvement.

"The Department of Health expects that Nice recommendations will be followed, although GPs obviously need to make their own clinical judgements.

"They are potentially letting themselves in for a bit of trouble if they don't follow them."