This plan is a "work-in-progress" based on the Caduceus Practice Plan circulated by the LMC. It is published online so that we can develop it appropriately. Please email DP with suggestions.
What type of incident are we planning for?
In preparing for emergencies it is often assumed the emergency will be a sudden and dramatic high impact incident such as major transport accident, terrorist attack, earthquakes or major flooding. These types of incidents are often referred to as ‘Big Bang’ incidents and provide responding agencies with, in most cases, a complete picture of what they need to deal with. The response phase is over, usually, within 48 hrs.
However, there is one type of emergency which takes time to unfold and may not be apparent until it reaches its tipping point. This is often called a creeping crisis and if not spotted in time can develop beyond control. Examples of these are: foot and mouth disease outbreak, and fuel dispute.
The current world crisis, Swine flu, began life as a creeping crisis with a spread in Mexico. Once WHO became aware and put measures in place to contain and monitor the outbreak the crisis was stopped before it reached its tipping point.
What we are dealing with now is termed a ‘rising tide’ incident. As the term suggests the incident is gradually building in size and picking up speed. Dealing with this type of incident can be quite frustrating as information needed to prepare arrives in stages and quite often requires changes to arrangements already in place. This slow development can cause one of the most dangerous attitudes an organisation can adopt, complacency.
Just because there appears to be little activity and the incident no longer makes the headlines doesn’t mean an organisation can go back to normal and forget it. An organisation needs to continue to monitor and prepare. The greatest attribute for any organisation facing a ‘rising tide’ incident is patience. The general feeling is that it is not a matter of if, but when and although we are now in a good state of preparedness it is important to keep on top of all our plans.
Background Pandemics have occurred on 3 occasions in the last century, with varying severity and impact on the UK population. These pandemics are believed to have derived from the transmission of novel strains of influenza, crossing the species barrier to form a novel human influenza.
During a pandemic primary care is expected to come under increased demand, at a time when its resources to cope with those demands will be degraded by the pandemic itself. It will have to prioritise and pool its resources to ensure the maximum amount of resilience; this document sets out how this will be achieved at a practice and locality level. It is the anticipation that a first wave of pandemic influenza will last 16 weeks, though in any given locality that wave is likely to be condensed and more pronounced.
Key points
o Additional demand for healthcare will mean that most influenza patients will require an initial assessment, as well as the majority of their subsequent care and support, outside of hospital healthcare settings.
o Patients will need to access care (including self care) in their own home or residential settings as far as possible to help reduce and limit the spread of infection.
o Up to 28.5% of symptomatic patients (including all children under 3 years of age) will require assessment and treatment by a GP or other appropriate health professional.
Overview of a Pandemic
This seeks to give a brief overview of a pandemic and plans as they apply to Primary Care and the planning assumptions made in constructing this plan, (these will be subject to change, both prior to and during a pandemic as more is known about the specific virus involved).
Pandemics have occurred regularly throughout modern history, and have been variable in their impact. Their mortality has varied from 0.3% and 2.5%, typically with a clinical attack rate of 25-35%. Worst case scenario planning assumes a clinical attack rate of 50% and a mortality of 3%.
Under these circumstances it is predicted that GPs will be subjected to at least an additional 310 per 10,000 patients additional consultations for patients with new cases of influenza in the peak week.
There is also likely to be additional work from the complications of influenza, bereavements, and the worried well, though this is difficult to quantify. Hospitals will not have the capacity to admit all those who might normally be admitted and alternative methods of care within the community are likely to be required for some. Primary care will have to deal with the bulk of these patients whilst also dealing with higher levels of staff and doctor sickness.
Treatment options may include:
o Pre-pandemic vaccination principally of health care workers) if vaccine has efficacy
o Antiviral therapy (stock piled and distributed by special measures)
o Antibiotic therapy for complications
o Pandemic specific vaccination (only likely to be available in quantity after the first wave) .
Practice based arrangements
Tactical day to day decision making would be made by the duty clinical manager and administrative managers. These persons would be selected from the available staff on each day, where possible the Management team would agree rota arrangements for key posts, but it recognised that this may not always be feasible.
Cluster based arrangements
The cluster membership will be defined in the pandemic period and will be determined on a geographical basis, with the mutual agreement of the partnerships and the PCT. It is acknowledged that the PCT would have powers to instruct staff and doctors as to their duties during a pandemic but would seek to facilitate planning arrangements through mutual consent. Our Cluster Lead is Teresa Dakin - 07908 327503
The Cluster Management team would normally consist of a doctor and manager from each practice. They would be responsible for strategic decision making, and would meet at the declaration of UK alert level 1 and at mutually agreed times thereafter or at the request an individual practice from the cluster. Tactical day to day decision making would be made by the duty clinical manager and administrative managers. These persons would be selected from the available staff on each day, where possible the Management team would agree rota arrangements for key posts, but it recognised that this may not always be feasible.
| Role | Person | Duties |
| Cluster Management Team | Representatives from each Practice (Clinical and or management) | Overseeing the cluster response to pandemic |
| Clinical Manager | Doctor | Overseeing the delivery of clinical care in the cluster |
| Administrative Manager | Manager from one of the practices | Organisation of all staff, and maintenance of priority services |
| Cluster Vetting Team | Nurse Practitioner / Nurse / Doctor | Day to Day prioritisation of clinical care and tasking of clinical delivery team |
| Cluster Call taking team | Reception staff | Taking details of requests for assistance and passing those that cannot be immediately allocated to the Vetting Team |
| Administrative support leader | Secretary | Collection of statistics for daily reporting |
| Cluster Clinical delivery team | Doctors, Nurses Allocated staff (HV, retired docs etc) | Delivery of clinical care and patient assessment at the direction of the Clinical Manager and Vetting Team |
Prioritisation of Workload and surgery arrangements
Suspension of routine work will ideally occur proactively when flu is deemed to be imminent within the locality, which will be advised by the PCT Influenza Outbreak Committee, or reactively when cases within the practice are beginning to be identified. This point will be called Flu Day One
On Flu Day One All chronic disease review and monitoring activity will be suspended. Patients with such appointments will be contacted by reception staff and advised of the cancellation.
The following enhanced services will be suspended :
o Contraceptive implants
o Sexual Health services
o Minor surgery
o Child immunisation (with the exception of primary immunisation)
o Alcohol Misuse
o Routine influenza immunisation
Enhanced services for DMARD and Anticoagulation will continue but length of time between tests will be reassessed to reflect reduced access to laboratory and phlebotomy services.
These changes will be made on a case by case basis, by an appropriate clinician. No new DMARD or anticoagulation will be accepted or initiated within the cluster unless it is assured by the initiator that appropriate monitoring can be achieved.
The following routine administrative tasks will be suspended:
o Appraisal
o Medicines management procedures
o Preparation of QoF submissions
o Practice Based commissioning work
o Choose and Book appointments
Other administrative duties may be delayed, such as year end accounts, with HMRC and Payroll payments being prioritised.
Out Patient referrals for non urgent assessment will be suspended, and lists of patients prepared within each practice as to who has not been referred. Letters for referral will be dictated at the time a decision to refer is made, and held for use in the recovery phase.
Urgent and 2 week referrals will continue to be made until we are advised that they can no longer be processed.
Referrals for investigations (chest x-ray, CT scan, exercise ECG) will need to be considered on a case by case basis, and will follow local guidance on capacity and priority. Any referrals deemed as non urgent will be prepared and/or dictated at the time and held for use in the recovery phase Referrals to in-house services will be suspended. Any potential such referrals will be listed and the need reassessed in the recovery phase.
Outside work undertaken by practices will be minimised, and where possible suspended it is not the role of the cluster to support practices in maintaining their outside commitments unless these directly impact upon acute patient care or the management of the pandemic. The practice will prioritise in the following order 1. Call Handling 2. Surgery arrangements for flu and urgent medical work 3. Visiting arrangements for flu and urgent medical work 4. Supporting care in the community 5. Routine work
Call handling Without effective call handling it will become impossible to allocate the limited resources available effectively. The high call volume and staff sickness will put pressure on the number of lines that can be open and staffed, diverting calls from one surgery to another whilst possible effectively depletes the number of lines patients can use to access the cluster Call handling will be preserved at a practice level for this reason until the point it becomes unsustainable, when lines will be diverted to the practice with greatest incoming line capacity.
Practice Opening times Practice opening times may alter in a pandemic and that staffing all the practices in the cluster fully throughout the pandemic may not be practical. Similarly it is accepted that demand on the health service may require extension of normal opening hours into the evening and weekend working It is recognised that some staff will have significant caring duties and child care issues during a pandemic due to sick dependents, and school closures, particularly during normal working hours and that by extending the cluster working time it may be possible to have them contribute to the response at times that fit in with these other commitments. Reconfiguration of the opening times will be carried out by the cluster management team as required. All decisions regarding this will be carried out in liaison with the PCT.
Service Provision The cluster will encourage practices to undertake all non influenza work in the first hour of the working day. This will make best use of this time of the day whilst the pandemic flu demand is being assessed and matched against available resources. It will also make sure that those not currently affected by influenza are assessed when the surgery is at its cleanest.
Adults not able to receive Oseltamivir via the National Influenza line due to being outside of their protocols will be first called by and then if necessary visited by a clinician. Children under the age of 3 will be home visited if required, but could if this becomes impossible due to lack of resources brought to a dedicated clinic in the afternoon. Those with complications of influenza will be assessed by home visiting or telephone consultation as required.
No appointments will be made purely for medical certification of illness. The location and staff carrying out these services will be allocated their duties by the cluster vetting team. Patients may be visited by staff with whom they are unfamiliar it is therefore essential that a means of identification is carried at all time .
Community Support It is recognised that due to the increased pressure on secondary care facilities, there may be need to support in the community patients who would normally be admitted. These people may be ill from influenza or other medical complaints The practice's ability to support these patients in the community will vary from day to day The practice will endeavour to identify those persons requiring enhanced home care and prepare contact sheet for each one for each day that they require enhanced medical input and resources will be allocated to them by the vetting team. The practice acknowledges that there will potentially be need to support the wider pandemic influenza response; this may mean the release of staff to support areas of need (clinical, administrative or managerial) within the PCT or wider area.
Staff issues Many staff will have different roles during a pandemic and that they will come under the control of the Clinical and Administrative leaders. Staff may be affected by caring duties, school closures in addition to individual sickness. Where possible those staff with these duties will be approached as to their availability to support early and late surgery opening when their other duties may more easily be shared with partners.
Infection Control Simple methods such as hand washing and surface cleaning are likely to be as important to our needs as masks and other barrier methods of protection. Where possible those members of staff who have recovered from the flu will be used to provide care to influenza patients, in preference to those who have not had the illness. No member of staff will be expected to work whilst symptomatic from influenza and will be sent home.
Prescribing Issues
o Repeat prescriptions
o Antiviral
o Antibiotic
o Antipyretics/symptomatic relief
The practice will continue to issue repeat prescriptions with the same frequency as normal, people will not be encouraged to stockpile drugs. Where possible post dated scripts will be issued for repeat medication so that the number of contacts to the practice for medication is minimised without significant impact on the pharmaceutical chain.
Antiviral medication will not be held by the practice or cluster, and will only be obtained from the local antiviral distribution centre.
Antibiotic therapy is not generally required by influenza suffers but may be required where there is a pre existing sepsis (Bronchiectasis, severe COPD); the diagnosis is unclear or there is marked deterioration in respiratory symptoms. Antibiotics used will be broad spectrum and should cover the usual respiratory pathogens, and Staph. Aureus. (Erythromycin, Co-amoxiclav, Quinolone).
The provision of symptomatic relief will generally be the responsibility of patient and their family. We are unlikely to have the capacity to become a "Calpol" and paracetamol dispensing service, Shortages are reported to the PCT for action as part of the daily return.
Community Care arrangements There are likely to be more people with influenza who might normally be admitted to hospital with influenza than can be accommodated by secondary care. Patterns of care in the community will need to reflect this reality. Triage decisions will need to be made following national guidance. There may need to be a lower tier of caring both in patients homes, by relatives or care services, and within residential nursing home and other ad hoc caring environments.
It is anticipated that the medical care for individual patients in their homes would be considered part of practice and cluster responsibility. The medical care for patients belonging to practices within the cluster living in local residential and nursing homes would be continued, though it may be more practical to share care for some of these homes with other clusters. This may be done at the instruction of the PCT.
Ethnic and Cultural issues The practice recognises that there will still be a need to respect and address cultural and ethnic issues where possible. Translation services are likely to be under severe pressure and should not be considered resilient, it is important to establish any linguistic abilities already present in the practices are identified and shared within the cluster. The cluster vetting team will have access a current edition of the Red Cross Emergency Multilingual Phrasebook.
Recovery Phase at a practice level
Eventually there will come a point when the flu cases fall to normal levels and normal levels of service will be need to be returned to. The point at which local health services can start the process of returning to normal will be called Recovery Day One At recovery day one the practice will:
o Determine when normal visiting and surgery arrangements can be restored
o Collate information on the impact of the pandemic on the physical and mental health of staff
o Collate information on the impact of the pandemic on the physical and mental health of patients.
o Collate information on the number of outstanding referrals and prepare relevant information for PCT Recovery plans
o Collate the cluster's views on local priorities for the restoration of normal services.
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THINGS YOU SHOULD DO NOW (Not in any particular order).
If a symptomatic patient contacts your practice, contact the Health Protection Unit in the first instance for advice regarding testing and provision of anti-virals.
Identify a practice contact who will be responsible for receiving, collating and disseminating to practice staff and the wider primary health care team any information or guidance received. Include any sessional staff or locums working with you. Please check that NHS Bradford & Airedale has the correct contact details.
Identify a multi disciplinary core team within the practice to include practice manager, lead GP, nurse and receptionist. Task these individuals with communicating information amongst their individual teams.
The PCT will be informing you of practice 'buddying up' arrangements. Please advise NHS Bradford & Airedale of any incorrect contact details on this sheet. Arrange for your practices core team to make contact with your 'buddying' practice or practices to convene a meeting to plan for future developments. Our Cluster Lead is Teresa Dakin - 07908 327503
NHS Bradford & Airedale will be making available a manager to liaise with clusters to provide appropriate support.
Ensure all your staff are updated as appropriate and supported about Swine Flu. Staff will probably be anxious and need explanation and support.
Carry out a risk assessment regarding personal protective equipment for staff. Ensure the practice has proper systems for infection control. Stock up on hand cleaning agents, paper towels, waste bins and liners as well as a supply of alcohol hand rub. Inform all staff of the importance of hand cleaning procedures. Review and implement cleaning policies within the premises. Remove none essential soft furnishings, toys and books from the waiting room to improve infection control.
Draw up a list of key telephone numbers including mobile numbers for all staff.
Display posters providing information to patients about Swine Flu and respiratory and hand hygiene.
Stock up on equipment supplies for nebulisers etc.
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THINGS YOU SHOULD DO SOON (Not in any particular order)
Produce a service continuity plan in the event of a national emergency.
Produce a business continuity plan in the event of a national emergency.
Check contingencies are in place in case of mains failure e.g. gas, water, electricity or IT equipment.
Consider options for segregating patients within the surgery (clean and dirty areas). It may be that practices are segregated into 'dirty and clean'.
Ensure any staff ID cards and photos are up to date (may be needed to obtain petrol and for use if visiting patients not registered with your practice).
Prepare an induction guide to the practice for staff who may be seconded from outside to work in the practice. Stock an emergency box to include face masks, gloves, aprons, torches and spare batteries and other consumables.
Discuss with staff working flexibilities and consider temporary variations to their employment contracts.
Draw up a list of the most vulnerable patients who may not proactively access healthcare e.g. those with a learning disability, those with mental health issues, the elderly and single people living alone with few contacts.
Order sufficient certification of death forms and cremation forms.
Consider developing a computer template for telephone consultations and triage.
Investigate options for telephone call diversion should calls need to be diverted to a 'buddying' practice.
Draw up a prioritisation list of tasks and services that can be suspended when notified to do so by the PCT. This will include prioritising business continuity as well as service continuity. There is agreement between the BMA and DH that practice funding will be maintained should practices be asked to suspend activities such as QOF or Enhanced Services.
Listed below are some of the current outstanding questions.
o Will the PCT deploy a team to carry out swabbing in the community?
o What is the system for making anti-viral medication available to patients and healthcare professionals?
o When will the PCT make available to practices a supply of FFP3 masks?
o Will the PCT continue to make available to practices supplies of surgical face masks, plastic aprons, goggles and gloves?
o Will practices be reimbursed the cost of overtime for staff working in a pandemic?
o Will the period of self certification of illness be extended from the current 7 days?
o For healthcare professionals coming into contact with confirmed cases on a regular basis can anti-viral prophylaxis be taken indefinitely?
o Will the HPU notify practices of any of their patients diagnosed as positive?
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This is the most up to date information that we are aware of. It is important that the practice flu lead is regularly accessing relevant websites in order to keep up with the latest information as this is a rapidly changing situation.
see: http://www.bradford.nhs.uk/Pages/SwineFlu.aspx
WHAT IS SWINE INFLUENZA?
This is an acute viral infection of the respiratory tract in pigs caused by Type A Influenza Virus. The virus also occurs in wild birds, poultry, horses and humans. Three Influenza Type A virus sub types, H1N1, H1N2 and H3N2 have been found in pigs. Recent cases of human infection have been with Influenza A (H1N1). This is a novel influenza and is resistant to the anti-viral medication Amantadine but is sensitive to Oseltamivir (Tamiflu) and Zanamivir (Relenza). Initially we had animal to human spread and now we have human to human transmission.
HOW COMMON ARE CASES OF SWINE INFLUENZA?
This virus has been detected occasionally in humans since the 1950s. It is clinically similar to the disease caused by infections with human influenza viruses. Cases in humans usually occur after a history of exposure to pigs. Person to person transmission has been previously reported but is rare. There have been no cases identified in the UK in the last ten years.
WHAT ARE THE SYMTOMS OF SWINE INFLUENZA?
Similar to seasonal influenza infection including fever, fatigue, lack of appetite, coughing and sore throat. Some people have reported vomiting and diarrhoea.
IS THERE A VACCINE AGAINST SWINE INFLUENZA? Yes, there is a vaccine available for pigs against Swine Influenza but as yet there is no vaccine to protect humans from Swine Flu.
IS THE SEASONAL INFLUENZA VACCINE EFFECTIVE AGAINST SWINE INFLUENZA?
There are some similarities between the human influenza viruses (covered by the seasonal vaccine) and the new H1N1 Swine flu viruses so some cross protection cannot be ruled out. Investigations are currently underway to determine whether this is the case.
CAN SWINE INFLUENZA IN HUMANS BE TREATED?
Most swine influenza viruses have been susceptible to anti-viral medications such as neuraminidase inhibitors Oseltamivir (Tamiflu) and Zanamivir (Relenza) and older anti-viral drugs the amantadanes eg (Lysovir). This current strain of swine influenza virus is susceptible to neuraminidase inhibitors but resistant to amantadanes
IS THIS THE NEXT INFLUENZA PANDEMIC?
It is too early to say. The Director General of the World Health Organisation (WHO) is responsible for declaring a pandemic and elevating the global stages of pandemic alert. The current level of alert is 5. The US centre for Disease Control and Prevention (CDC), the European Centre of Disease Prevention and Control (ECDC), the European Commission together with its member states and the WHO regional office for Europe are monitoring and assessing the situation closely. If the level of alert is raised to 6 then we will have pandemic.
WHAT IS THE INFECTIOUS PERIOD?
The infection should be considered potentially contagious for seven days from illness onset. Patients who continue to be ill longer than 7 days after onset of illness should be considered potentially contagious until symptoms have resolved. Younger children might potentially be contagious for longer periods. Non-hospitalised ill patients who are confirmed or suspected cases are recommended to stay at home (voluntary isolation) for at least the first seven days after illness onset if possible.
WHAT IS THE CASE DEFINITION FOR INFECTION WITH SWINE INFLUENZA (H1N1) VIRUS?
A confirmed case of Swine Influenza A (H1N1) virus infection is defined as a person with an acute febrile respiratory illness with a laboratory confirmed Swine Influenza A (H1N1) virus infection by one or more of the following tests: 1. Real time RT-PCR 2. Viral culture A probable case of swine influenza A (H1N1) virus infection is defined as a person with an acute febrile respiratory illness who is: 1. Positive for Influenza A, but negative for H1 and H3 by influenza RT-PCR or 2. Positive for Influenza A by an influenza rapid test or an influenza immunofluorescence assay (IFA) plus meets the criteria for a suspected case. A suspected case of Swine Influenza A (H1N1) virus infection is defined as a person with acute febrile respiratory illness with onset: 1. Within seven days of close contact with a person who is a confirmed case of Swine Influenza A (H1N1) virus infection, or 2. Within seven days of travel to a community internationally where there are one or more confirmed Swine Influenza A (H1N1) cases or 3. Resides in a community where there are one or more confirmed Swine Influenza cases. Close contact is defined as: Within about six feet of an ill person who is a confirmed or suspected case of Swine Influenza A (H1N1) virus infection. Acute respiratory illness is defined as recent onset of at least two of the following: rhinorhea or nasal congestion, sore throat, cough (with or without fever or feverishness). Clinicians should consider Swine Influenza A (H1N1) virus infection in the differential diagnosis of patients with febrile respiratory disease and who have returned from an area of outbreak. Likewise those patients who present with a febrile respiratory illness who have been in close contact with patients returning from such an area.
WHAT ARE THE INFECTION CONTROL MEASURES FOR AN ILL PERSON?
Patients with suspected or confirmed case status should isolate themselves voluntarily at home if possible. The ill person should wear a surgical mask when this isolation needs to be broken and should be encouraged to wash hands frequently and follow respiratory hygiene practices.
Cups and other utensils used by the ill person should be washed with soap and water before use by other persons. Personnel providing care to or collecting clinical specimens from suspected or confirmed cases should wear a face mask, a plastic apron and disposable none sterile gloves. Personnel engaged in aerosol generating activities e.g. nebuliser treatment should use an FFP3 mask.
WHAT VISUAL ALERTS SHOULD BE USED?
Posters should be placed at the entrance to health care premises instructing patients and persons who accompany them to inform health care workers of symptoms of a respiratory infection when they first request consultation and to advise them to practice respiratory and hand hygiene/cough etiquette.
WHAT IS RESPIRATORY AND HAND HYGIENE / COUGH ETIQUETTE?
The following measure to contain respiratory secretions are recommended for all individuals with signs and symptoms of a respiratory infection:
Cover the nose/mouth when coughing or sneezing.
Use tissues to contain respiratory secretions and dispose of them in the nearest waste bin after use.
Perform hand hygiene e.g. hand washing with soap and water or alcohol based hand wash (after having contact with respiratory secretions and contaminated objects/materials).
Health care providers should ensure the availability of materials for adhering to respiratory and hand hygiene / cough etiquette in waiting areas for patients.
Provide tissues and receptacles for used tissue disposal.
Provide conveniently located dispensers of alcohol based hand rub. Ensure supplies for hand washing e.g. soap and disposable towels, are consistently available.
Offer face masks to people who are coughing.
When space and chair availability permits, encourage coughing persons to sit at least three feet away from others in common waiting areas.
Advise health care workers to observe droplet precautions e.g. wearing a face mask for close contact when examining a patient with symptoms of respiratory infection.
WHERE SHOULD THE PATIENT BE ASSESSED?
Preferably at home. If at your surgery, then the assessment should be undertaken away from communal areas. Once assessed, if the patient is well enough to be at home then they should be advised to stay there. Give advice about: Seeking help if clinical condition worsens. Avoiding contact with other people until the results of tests are known. Respiratory and hand hygiene. Cleaning hard surfaces regularly with a standard cleaning preparation. If the patients needs hospital admission than please arrange this, ensuring the admitting team and any ambulance staff are informed of the potential diagnosis and that the patient must be placed in an isolation room.
The patient should wear a face mask (except while having samples taken). The staff member taking the swabs should wear a face mask, plastic apron and gloves.
HPU will advise you regarding local arrangements for the supply of anti-virals.
CAN I PRESCRIBE ANTI-VIRALS ON AN FP10?
They are not prescribable on an FP10 - legislation went through Parliament on 30 April.
DO I OR ANY OF MY STAFF NEED ANTI VIRALS?
You do not need to take anti-virals ahead of the sample result. If the patient samples prove positive for influenza A then you will be assessed for anti-viral prophylaxis by the HPU.
WHAT SHOULD I DO ABOUT THE CLOSE CONTACTS OF THE PATIENT?
If the case meets the criteria for testing for Swine Influenza A then you should advise the patient to inform their close contacts and for these individuals to be vigilant for flu like symptoms. The HPU will also take information about close contacts but further action will only be required if the index case samples prove positive for Influenza A. The laboratories will be performing the assays at least twice a day and the results will be notified to the health professional.
In line with national agreements between the Health Protection Agency (HPA) and the NHS, we are setting up a regional call centre to handle enquiries from health professionals related to the current Influenza A/H1N1 (Swine flu / Mexican flu) situation.
The aims of this call centre are: To support the efforts to contain the spread of Influenza A/H1N1 in the UK To support frontline health professions in delivering speedy and appropriate care to affected individuals To ensure good quality surveillance to permit intelligence driven management of a potential influenza pandemic
The call centre is for health professionals only to report suspected cases and their contacts. Members of the public will continue to be directed to NHS Direct telephone and online facilities as the first contact point.
The call centre will be managed by senior NHS and HPA nurses with an experienced Consultant in Communicable Disease Control present at the call centre at all times.
The call centre will be open between the hours of 8 am and 8 pm, 7 days a week, starting Tuesday 12 May 2009. The telephone number for the call centre is 0845 2700899
Outside call centre hours, health professionals are advised to continue to use existing public health on call arrangements.
Health professionals are encouraged to use this new flu call centre as this will be the quickest route to obtaining appropriate advice and support for influenza A/H1N1 related enquiries. All other health protection enquiries, including support for emergency planning, should be directed to your local health protection unit as usual. Thank you for your support with this situation. Please share this information with all relevant colleagues, including locum doctors, and out of hours service providers.