PCA(P)(2025)10 - Updated Men B Paracetamol Service Spec
Published: 22/05/25
Introduction
This Circular advises Health Boards and community pharmacy contractors of an updated service specification for the community pharmacy provision of prophylactic antipyretic (paracetamol) following the meningococcal group B vaccine; and other childhood vaccinations. It also provides supporting clinical guidance.
Background
Directions for the Public Health Service enable community pharmacists to provide prophylactic antipyretic (paracetamol) following the meningococcal group B vaccine; and other childhood vaccinations. The current version is the Health Board Additional Pharmaceutical Services (Public Health Service) (Scotland) Directions 2023 (“2023 Directions”).
NHS Circular PCA(P(2015)25 issued on 28 September 2015, announced the introduction of prophylactic antipyretic (paracetamol) and enclosed the original service specification.
The clinical guideline on prophylactic antipyretic (paracetamol) has recently been revised which has led to the necessity to update the pharmacy service specification.
Fever is a common side-effect when infants are given the MenB vaccine with other routine childhood vaccines.
The Joint Committee on Vaccination and Immunisation (JCVI) recommends that paracetamol should be given prophylactically when the MenB vaccination is given with the routine vaccines in infants under one year of age, to prevent or reduce fever. The JCVI statement about Meningococcal Group B disease and the Men B vaccine is available at Meningococcal B vaccine: JCVI position statement - GOV.UK.
Details
Documents attached to this circular are as follows:
The key change to the service specification is eligibility for using the pharmacy service. Due to updates to the clinical guidance, the pharmacy prophylactic paracetamol service will be available as off-label use to infants who meet specific criteria in terms of standard paracetamol dosing. This represents the vast majority of infants where pharmacy can provide a safe and appropriate service.
As indicated in the 2015 circular announcing the introduction of the pharmacy service, it does not replace existing GP practice responsibilities, but provides a complimentary service. In rural areas it may be more practicable for patients to access this from their GP practice. More vulnerable infants e.g. those with low weight or with existing health conditions, should be provided a prescription and remain under their care of their GP practice or specialist team. However, the majority of infants requiring prophylactic paracetamol will be eligible to do so via their local community pharmacy.
For infants who do not meet the updated eligibility criteria for the pharmacy service, health boards are responsible for ensuring arrangements are in place for them to receive a timely supply of prophylactic paracetamol following vaccinations.
New clinical guidance
Clinical guidance has been produced for use by all pharmacy teams by Healthcare Improvement Scotland (HIS) in collaboration with Public Health Scotland (PHS) and the Scottish Neonatal and Paediatric Pharmacists Group (SNAPP). This guidance is not a Patient Group Direction (PGD) but is intended to give consistent guidance to pharmacists across Scotland. It is attached to the service specification at Annex A.
Some health boards may have local PGDs in place for Meningitis B prophylactic paracetamol. Where these are in operation, health boards should ensure they are communicated to community pharmacy contractors who should ensure their teams are aware of the local pathways.
There is no specific e-learning module to be completed for this service but a paediatric module, giving information on childhood immunisations and prophylactic paracetamol, is available on NES Turas Learn: Paediatric pharmacy : Childhood issues.
IT arrangements
Pharmacy teams should use the ‘Men B supply’ Universal Claim Framework (UCF) module to claim for each supply of Meningitis B prophylactic paracetamol. This supports accurate monitoring of service use and payments. The Pharmacy First UCF module should not be used.
Claims for prophylactic paracetamol should only be made where a supply has been undertaken as part of the NHS Community Pharmacy Public Health Service and not where a person is purchasing paracetamol for other indications.
