Revealed: NHS failing to support GPs over swine flu workload surge
Thursday, June 18, 2009
16 Jun 09
By Steve Nowottny
Exclusive: Primary care organisations are struggling to offer GPs support in coping with what is expected to be a huge surge in swine flu workload, because of concern over costs and confusion over the most appropriate response, a Pulse investigation reveals.
A survey of 45 PCOs across the UK portrays a chaotic and patchwork picture as the NHS prepares to move from the ‘containment’ to ‘mitigation’ phase of the outbreak.
Use of antivirals for close contacts of confirmed cases has already been restricted to those at most risk of contracting the virus, following the declaration of a pandemic by the World Health Organization.
At last week’s LMCs conference in London, the GPC warned practices faced an ‘impossible’ workload. But Pulse has learned that PCOs are floundering in their response to the outbreak, with some cancelling support services because of ‘excessive’ costs.
Only one trust in three has put in place systems to contact locums or retired GPs to enlist their help, despite that being a key part of the Department of Health’s flu planning advice.
Just one trust in four has commissioned support services to stop GPs from being overwhelmed, and only a similar proportion are monitoring practices to ensure buddying-up arrangements are in place.
Practices face a lottery in provision of facemasks, swabs and antivirals, with some trusts issuing protective equipment while others insist it is GPs’ responsibility to buy their own.
Moves to enlist use of out-of-hours services to help cope with the flu workload were also thrown into doubt, as it emerged at the LMCs conference that three PCTs had cut funding to the service in Birmingham spearheading Europe’s biggest outbreak, reportedly because costs were ‘excessive’.
Dr Fay Wilson, chair of conference and medical director of the out-of-hours service, condemned the decision, describing it as ‘a kick in the guts’.
A spokesperson for the three PCTs said the decision followed ministers’ indication ‘that we are now moving to the mitigation phase’, although the DH denied that this was yet the case. A formal decision is not expected to be made until health secretary Andy Burnham meets the civil contingencies committee later this week.
Our survey findings come just days after a 38-year-old woman in Glasgow became Britain’s first swine flu fatality.
As Pulse went to press, the Health Protection Agency was reporting 1,320 confirmed cases of swine flu in the UK – a figure expected to rise sharply.
The response by both PCTs and the HPA came in for fierce criticism at the LMCs conference, with angry delegates refusing to rubber-stamp a motion praising the HPA, and complaining of antiviral shortages and delays in advice.
Dr Paul Roblin, chief executive of Berkshire, Buckingham-shire and Oxfordshire LMCs, said the HPA had shown an ‘astonishing’ lack of preparedness.
The HPA said it was ‘continually reviewing’ its response arrangements.
But GPC negotiator Dr Peter Holden warned the impact of swine flu on hard-hit areas could be disastrous. ‘The workload on those practices locally is impossible in the medium term and it’s difficult in the short term.’
Swine flu – the unresolved issues
Supplies: GPs facing postcode lottery over supplies of personal protective equipment, with some trusts supplying practices and others telling GPs to buy their own
Mobilising reserves: PCTs are supposed to be drawing up lists of locums and retired GPs who can be called upon in a full-blown pandemic, but two-thirds have yet to do so.
Legal issues: The BMA and NHS Employers are still thrashing out an agreement on indemnity coverand death-in-service payments for locums
HPA guidance: LMC leaders have complained that some HPA advice has been delayed and GPs have found guidance confusing
By Steve Nowottny
Exclusive: Primary care organisations are struggling to offer GPs support in coping with what is expected to be a huge surge in swine flu workload, because of concern over costs and confusion over the most appropriate response, a Pulse investigation reveals.
A survey of 45 PCOs across the UK portrays a chaotic and patchwork picture as the NHS prepares to move from the ‘containment’ to ‘mitigation’ phase of the outbreak.
Use of antivirals for close contacts of confirmed cases has already been restricted to those at most risk of contracting the virus, following the declaration of a pandemic by the World Health Organization.
At last week’s LMCs conference in London, the GPC warned practices faced an ‘impossible’ workload. But Pulse has learned that PCOs are floundering in their response to the outbreak, with some cancelling support services because of ‘excessive’ costs.
Only one trust in three has put in place systems to contact locums or retired GPs to enlist their help, despite that being a key part of the Department of Health’s flu planning advice.
Just one trust in four has commissioned support services to stop GPs from being overwhelmed, and only a similar proportion are monitoring practices to ensure buddying-up arrangements are in place.
Practices face a lottery in provision of facemasks, swabs and antivirals, with some trusts issuing protective equipment while others insist it is GPs’ responsibility to buy their own.
Moves to enlist use of out-of-hours services to help cope with the flu workload were also thrown into doubt, as it emerged at the LMCs conference that three PCTs had cut funding to the service in Birmingham spearheading Europe’s biggest outbreak, reportedly because costs were ‘excessive’.
Dr Fay Wilson, chair of conference and medical director of the out-of-hours service, condemned the decision, describing it as ‘a kick in the guts’.
A spokesperson for the three PCTs said the decision followed ministers’ indication ‘that we are now moving to the mitigation phase’, although the DH denied that this was yet the case. A formal decision is not expected to be made until health secretary Andy Burnham meets the civil contingencies committee later this week.
Our survey findings come just days after a 38-year-old woman in Glasgow became Britain’s first swine flu fatality.
As Pulse went to press, the Health Protection Agency was reporting 1,320 confirmed cases of swine flu in the UK – a figure expected to rise sharply.
The response by both PCTs and the HPA came in for fierce criticism at the LMCs conference, with angry delegates refusing to rubber-stamp a motion praising the HPA, and complaining of antiviral shortages and delays in advice.
Dr Paul Roblin, chief executive of Berkshire, Buckingham-shire and Oxfordshire LMCs, said the HPA had shown an ‘astonishing’ lack of preparedness.
The HPA said it was ‘continually reviewing’ its response arrangements.
But GPC negotiator Dr Peter Holden warned the impact of swine flu on hard-hit areas could be disastrous. ‘The workload on those practices locally is impossible in the medium term and it’s difficult in the short term.’
Swine flu – the unresolved issues
Supplies: GPs facing postcode lottery over supplies of personal protective equipment, with some trusts supplying practices and others telling GPs to buy their own
Mobilising reserves: PCTs are supposed to be drawing up lists of locums and retired GPs who can be called upon in a full-blown pandemic, but two-thirds have yet to do so.
Legal issues: The BMA and NHS Employers are still thrashing out an agreement on indemnity coverand death-in-service payments for locums
HPA guidance: LMC leaders have complained that some HPA advice has been delayed and GPs have found guidance confusing
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