Information
COVID antiviral treatments for high-risk non-hospitalised patients are prescribed by a stand-alone service in NHS Lothian. Patients who have tested positive for COVID-19 (on LFT or PCR) and who are considered high-risk (as defined in Section 5 of NICE TA878) may be eligible for antiviral treatment. Patients will not have to attend an NHS Lothian site to receive antiviral treatment; they should follow current isolation guidance. Antiviral treatment will be delivered from dedicated community pharmacies, or can be collected by a patient’s representative, usually on the same day the patient is contacted.
C.W. & E.B.R 06-09-23
Patients self-refer to the service by phoning the Flow Navigation Centre (FNC) on 0300 790 6769. This single point of contact is available Monday to Friday, 9am-5pm. At the time of writing this service is available at weekends also. If these phone lines are closed patients should follow the instructions on the voicemail. Patients should self-refer as soon as possible after testing positive on LFT/PCR, as treatment is most effective when started early. Referrals are triaged, then patients will be assessed by a primary care pharmacist for eligibility and suitability of the treatment.
Non-hospitalised adult patients (≥18 years) are considered to be eligible for oral antiviral treatment if:
- SARS-CoV-2 infection is confirmed by either lateral flow test (LFT) or polymerase chain reaction (PCR) testing, and;
- They are symptomatic with COVID-19 and are showing no signs of clinical recovery, and;
- The patient is a member of a ‘highest’ risk group (as defined in Patients_considered_to_be_at_highest_risk_of_Adverse_Outcomes_from_COVID-19.pdf (nhsscotland.net) and;
- Their symptom onset is within 5 days at the time of referral, and;
- They have not been treated with COVID antiviral therapy in the preceding 30 days.
Note that the above document Patients_considered_to_be_at_highest_risk_of_Adverse_Outcomes_from_COVID-19.pdf (nhsscotland.net) is the same as Section 5 of NICE TA878 but contains additional explanatory notes.
Patients that are registered with a GP in NHS Lothian or those who are on holiday in Edinburgh or the Lothians can all access treatment via this route. Patients who are not geographically located in Edinburgh or the Lothians at the time of referral should contact their nearest health board or healthcare provider. See the Resources and Links tab for further information.
GPs remain responsible for the clinical assessment of patients with COVID-19. A symptom check will be undertaken by the COVID antiviral service team to ensure that patients are symptomatic (a requirement for treatment) and that their symptoms do not warrant further clinical assessment by their GP. If patients report any red flag symptoms, they will be advised to seek medical attention. For further resources on the management of COVID 19 in Primary Care, see the Primary Care Management tab.
GPs should follow national clinical guidelines for the care and assessment of patients with COVID-19 in community settings: https://www.nice.org.uk/guidance/ng191
Casirivimab plus imdevimab, nirmatrelvir plus ritonavir, sotrovimab and tocilizumab for treating COVID-19. NICE Technology Appraisal Guidance [TA878]. Published 29/03/23, last updated 22/06/23. Accessed via https://www.nice.org.uk/guidance/ta878/chapter/5-Supporting-information-on-risk-factors-for-progression-to-severe-COVID-19
NICE COVID-19 Rapid Guideline [NG191]: Managing COVID-19. Published 23/03/21, last updated 22/06/23. https://www.nice.org.uk/guidance/ng191
Treatment-of-non-hospitalised-patient-with-COVID-guideline-v1.0-1-1.pdf
NHS Inform Coronavirus (COVID-19). All up to date information for patients regarding COVID, treatments and the contact details for other NHS Scotland health boards can be found at: https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/coronavirus-covid-19-treatments
