Important Londonwide CEO message number 6 - 29 June 2009

Please see below which now confirms the move to clinical diagnosis and judgement, the end of swabbing, and the flexibility to prioritise your workload. Please continue to send us your concerns via flu@lmc.org.uk. We will continue to work with the authorities to ensure that appropriate lessons are learned. We will also be seeking some certainty around practice contractual payments and will update you as soon as there is any news.

NHS London and HPA London recommend that GPs can now move to providing treatment only at their discretion, based on clinical indication. This means that GPs are able to cease swabbing and contact tracing. This applies to all clinicians, including those in A&E.

Ministers have agreed the following with regard to handling hot spot areas around the country, which recognises and expands on some of the actions we are already taking in London:

• cases of swine flu may be determined by clinical diagnosis as opposed to swabbing and laboratory testing
• it is recognised that GPs who are under severe pressures will use their clinical judgement on how best to prioritise their workload
• appropriate antiviral treatment should continue to be offered to all symptomatic cases
• contact tracing of symptomatic patients and the prophylactic use of antivirals can cease, except in circumstances where it is clinically indicated