Important Londonwide CEO message number 17 - 4 August 2009
Swine Flu
At last, some respite. Surgery call levels are now a quarter of what they were 2 weeks ago in most parts of town. Politicians will claim this to be due to the success of the flu line. The epidemiologically predictable school holiday lull was of course a mere coincidence of timing. In fact the flu line figures for London after the first week or so of operation show that compared with the first week, the number of cases handled by both the online and phone service, has dropped by ¾. In any case, so far for August, 8104 cases have been handled by NPFS, of which 5565 vouchers were issued, of which only 3736 were collected. Out of a population of 10 million, my money’s with the epidemiologists, and the strong messages we’ve all been issuing about self-help, context, side effects of Tamiflu and resistance. Apparently the wholesale cost of thermometers to retail pharmacies has doubled!
Swine Flu 2 – the Sequel
So we await the next phase, expected to take off mid September.
Key issues:
- PCT behavioural problems: Some PCTs are already contacting you as part of their need to invent their own wheels while national negotiations are going on about contractual arrangements which will save them the bother. Please don’t drag yourselves off the city’s golf courses to respond, unless these have been cleared through the LMC. We will let you know if such approaches have been so cleared. If you have any concerns, let us know via flu@lmc.org.uk.
- National Pandemic Flu Service and GP Liability: Please see below the clarification we now have from DH:
NPFS and GP liability
The legal liability for any errors, missed diagnoses etc for the telephone based advice/antiviral authorisation service and the web based service rests with the NPFS and therefore with DH. For errors/omissions at the collection points it will be with the PCT. The GP is not legally responsible.
It is policy that patients should use the NPFS so advising patients with flu symptoms to do so does not result in a legal risk to GPs. If the patient has non-flu symptoms and is unwell then advice will be given by the NPFS to contact/re-contact the GP who then thereafter resumes the normal legal and clinical responsibility for their own acts/responsibilities.
As regards concerns regarding the GMC, there is a revision on the GMC web site for Good Medical Practice to cover issues raised by Pandemic Flu. GPs who are concerned should read it and if they feel that the GMC has not covered their concerns they should inform the GMC either directly or through the BMA or RCGP. [our insertion – or LMC]. The GMC recognises that the system will be under pressure and that standards may have to be relaxed. It would depend on the circumstances of any omission/ act which from the document would have to be clearly out of line with the ‘normal’ level of practice at that point of time in the pandemic to result in criticism.
- Vaccinations: discussions are still ongoing, even at this late stage, on the contractual and operational arrangements to be operated. Please try to ignore painful spoiler stories planted by the tabloids (aka Daily Mail) probably designed to undermine those negotiations. In the meantime, it would be sensible to make provisional arrangements in surgery time for the eventuality of mass vaccination - 2 doses a month apart for under 15s, pregnant and at-risk patients, to be drawn up from larger vials, as well as the usual winter flu campaign. Some patients will therefore need 3 jabs. How this will be funded remains the job of our national negotiators to agree. Watch this space.
- Suspension of non-essential work in the event of a surge: Also under national negotiation. Nothing yet agreed. We will let you know as and when. Don’t hold your breath.
Finally, a message to Practice Managers: Please complete our very quick online survey, which takes moments to complete. It will really help us help you when the fan is proverbially hit.