All information is correct at time of printing and is subject to change without notice. The Devon Formulary and Referral Website is not in any way liable for the accuracy of any information printed and stored by users. For the most up-to-date information, please refer to the website.
Oral antivirals can now be prescribed in primary care. Medication stocks are now available for eligible patients via community pharmacies as well as through CMDUs.
Also, eligible patients can now collect lateral flow tests from community pharmacies.
Please refer to the Devon Formulary guidance to aid appropriate and safe prescribing in the community – including checking for drug interactions, contraindications and dose change requirements e.g. for impaired renal function.
Do not prescribe Paxlovid without carefully considering whether it is appropriate for the patient.
There is also prescribing training available the NHS Learning Hub here.
So, GPs may either assess and:
OR
Do not prescribe Paxlovid without carefully considering whether it is appropriate for the patient. Determine whether the patient meets the initial assessment criteria for a COVID-19 treatment and then assess for suitability for Paxlovid.
For more information, refer to Formulary guidance COVID-19 treatments for patients who do not require hospitalisation: N&E Devon / S&W Devon
Antivirals and the nMAB, sotrovimab, are recommended for non-hospitalised patients with COVID-19 who have risk factors for progression to severe COVID-19. Criteria for treatment are outlined in NICE TA878.
1) Initial assessment for consideration of a COVID-19 treatment
The patient should meet ALL of the following to be considered for treatment:
COVID-19 test | Positive SARS-CoV-2 infection lateral flow test or Polymerase chain reaction (PCR) testing |
Date of onset of COVID-19 Symptoms | Onset of symptoms of COVID-19 within the last 5 days |
Severity of COVID-19 infection | Does not require hospitalisation or supplemental oxygen for COVID-19 |
Clinical history | At increased risk of progression to severe COVID-19 ( patient groups are defined in NICE TA878)*
Adults: risk factors for progression to severe COVID-19 Young people aged 12 to 17 years risk factors for progression to severe COVID-19 |
Age and Weight | NOT under 12 years or weighing less than 40kg** |
*If there is any uncertainty, CMDU Advice & Guidance should be considered.
**There are no routine treatment options for children under 12 years or weighing less than 40kg. GPs should contact the child’s specialist team directly.
Please Note: patients should be made aware that not all patients within “high risk” groups will need treatment e.g., neurological conditions, if mild and not on immunosuppressive treatment.
2) Other referral pathways should be utilised in parallel as appropriate.
Other Essential Information:
This information is essential for safe prescribing of COVID-19 antiviral medication.
Patients who require hospitalisation for COVID-19 should be referred to an acute trust. See:
SARS-CoV-2 polymerase chain reaction (PCR) or lateral flow testing within the last 5 days
Advice on when to test
The advice from NHS England states:
‘If you have Covid symptoms you should take a test immediately, even if your symptoms are mild.
If your test is negative but you continue to have symptoms, you should take another test on each of the next two days (three tests in total over three days).
You should report your test result where possible at https://www.gov.uk/report-covid19-result or by calling 119, using your NHS number and postcode (at the top of this letter). This will ensure your test result is visible to the NHS, to support referral and assessment.
You will not be able to report the result of a test purchased from a pharmacy or shop, but this will not affect your access to an assessment for treatment.’
COVID-19 rapid guideline: managing COVID-19
If safe to be managed in the community:
If eligible:
Oral antivirals can now be prescribed in primary care. Medication stocks are now available for eligible patients via community pharmacies as well as through CMDUs.
Please refer to the Devon Formulary guidance to aid appropriate and safe prescribing in the community – including checking for drug interactions, contraindications and dose change requirements e.g. for impaired renal function.
Do not prescribe Paxlovid without carefully considering whether it is appropriate for the patient.
So, GPs may either assess and:
Please see the Devon Formulary guidance for prescribing advice:
There is also prescribing training available the NHS Learning Hub here.
A list of those eligible for these treatments can be found on the referral form and on the national website here – under ‘Recommendations update: Box 1 and Box 2’. This list does change, so it is important to check when assessing a patient with a positive COVID-19 test.
PANORAMIC study
Oral antivirals will be made available to a wider cohort of at-risk patients through a national study known as the PANORAMIC study. Further information is available here: PANORAMIC trial. Patients eligible for nMABs or oral antivirals under this guidance should be offered treatment in the community and not be referred to this study.
a) In Hours Referral (access to e-RS):
If a patient meets the eligibility criteria, patients should be referred using the referral template to a CMDU by searching for the CMDU services on eRS:
e-Referral Service Selection
Specialty: Infectious Diseases
Clinic Type: A&G
Service: There will be an option for a service that includes ‘CMDU’ in the name
If an A&G option is not available on e-RS for your local CMDU, please use the direct referral option below. If appropriate, and asked for, advice may still be provided via the below option.
e-Referral Service Selection
Specialty: Infectious Diseases
Clinic Type: Not Otherwise Specified
Service: There will be an option for a service that includes ‘CMDU’ in the name
b) Out of Hours (OOH) / NHS111 (no access to e-RS)
If a patient meets the eligibility criteria, patients should be referred using the referral template to a CMDU and emailed to the appropriate CMDU:
Referral form nMAB community access - no merge fields
Treatments for coronavirus (COVID-19) - NHS
Easy read and other language versions of this information are available from: Treatments for COVID-19 – Easy Read - NHS
This guideline has been signed off on behalf of NHS Devon.
Publication date: January 2022
Updated: January 2024