Ian Dalton's swine flu update - instructions for PCTs and GPs

What should NHS staff be focusing their efforts on?

The latest figures from the Health Protection Agency show only a small increase in the rates of influenza like illness, with an estimated 84,000 cases as of 5 November, up from 78,000 the previous week. That the growth is relatively small is welcome but there have been still further increases in hospitalisations, patients in critical care and the number of deaths related to swine flu, which is a trend that continues to worry us. Figures show that of the people who have died as a result of swine flu so far in this country, around two thirds were in the priority groups for the swine flu vaccination, and therefore would have been eligible to receive it. This figure alone highlights the potential of the vaccination programme to save lives.

As I mentioned last week, organising the vaccination campaign at such short notice has been a huge logistical effort for the NHS, and it is a credit to everyone involved that the programme is on track and is now starting to offer people vital protection against the swine flu virus. We previously said that it would take around three to four weeks to complete distribution of the first supplies to all GP practices. While this is still the case, I am pleased to say that the vast majority of practices will receive their delivery within 3 weeks (i.e. by 13 November).

The next steps

Our vaccination campaign is working well and is already saving lives. Now is the time for all NHS organisations to consolidate the hard work carried out to date so that we can vaccinate as many people as quickly as possible.

PCTs and GPs will be aware that children with chronic neurological conditions are at particular risk of developing complications from swine flu, and as such are part of the priority groups for the vaccine. GPs will want to ensure that they offer the vaccine to children with these conditions on their registers as rapidly as possible.

I expect that all PCTs will continue to give the highest priority to ensuring that the vaccination of high-risk groups runs smoothly in their areas and that both GPs and their patients are well informed about the progress of this important public health campaign. I have recently written to the NHS with further details about the vaccine programme but in short they should:

1. Ensure that every GP practice is aware of when vaccine is scheduled to arrive and when and how to get additional supplies;
2. Ensure that robust arrangements are in place for the vaccination of patients with confirmed egg anaphylaxis and that all GPs are aware of how to refer patients to them;
3. Ensure that robust arrangements are in place for the vaccination of priority children within residential settings;
4. Work with the governors of any local prisons to vaccinate appropriate staff and prisoners.

I also expect that all NHS organisations will continue to ensure that as high a proportion of eligible staff are vaccinated as possible.  A range of resources have been made available to those delivering the programme, and can be found on the Department of Health’s website at www.dh.gov.uk/swinefluvaccinetools. 

The national pandemic flu service was set up to relieve the burden on the frontline primary care service as much as possible by providing a separate route to access and collect antivirals. With the vaccination programme now rolling out, it is as important as ever to direct those not in the priority groups to that service. We have seen a levelling off of people using the NPFS and to ensure that there isn’t an unnecessary burden placed on GPs and frontline staff, the Department of Health will be running a short public facing campaign to raise awareness again.

Progress to date

All the latest information on the current increase in numbers of flu like illnesses, GP consultation rates, hospitalisations and deaths can be found on the HPA website.

The most up-to-date clinical information and guidance can be found on the Department of Health website at http://www.dh.gov.uk/en/Publichealth/Flu/Swineflu/InformationandGuidance/index.htm  including recently published advice for clinicians caring for pregnant women.