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Are we geared up for pandemic flu?
Are we geared up for pandemic flu?
Posted by Sniffles on P4P
In October last year, the Chief Medical Officer for England warned a pandemic of influenza could kill 50,000 people in Britain, if not this year, then soon. One year on, the threat remains and leading doctors question whether we are doing enough to prepare.
Dr Bruce Taylor, who has advised the Government on flu planning, said given the 37-year cycles of flu, another pandemic is overdue and that we should expect one within three years.
He said good progress had been made with planning for this pandemic, but several issues were still to be resolved. For instance, oxygen manufacturers had guaranteed increased supply, but the logistics and transport could not be guaranteed if, for instance, lorry drivers were struck by flu.
Dr Taylor, a consultant in critical care medicine at Queen Alexandra Hospital, Portsmouth, added that issues such as legal cover for doctors working beyond their competencies in emergency situations needed to be ironed out.
'It makes me worried - for all the work we're doing, it will be a nightmare and we will be faced with really hard choices,' he told Hospital Doctor.
Dr Tony France, an infectious diseases consultant at Ninewells Hospital, Dundee, agrees that there are still serious challenges to come and is concerned that simple issues such as childcare arrangements for nurses could exacerbate an expected 30 per cent absence rate and 'severely strain' the NHS.
From one GP's perspective, inadequate communication has been a major concern. Dr Simon Stockley, a member of the Government's joint working group on pandemic flu, who practises in Teesside, said: 'GPs are still unsure of what is required of them and are unsure of what plans are being put in place. People on the front line have only a small amount of knowledge of what's being planned.'
Despite these concerns about preparedness, the DoH is taking the threat seriously. Stockpiles of 14.6 million courses of antivirals - enough to treat the quarter of the population expected to fall ill - are due to be completed later this month. But draft DoH guidance seen by Hospital Doctor suggests this 25 per cent 'attack rate' may be a best-case scenario.
A DoH spokeswoman said: 'A flu pandemic could be very serious. It makes sense for the UK to be as prepared as we can be. Preparation for a pandemic is ongoing and we are constantly reviewing and developing our plans in light of emerging information and international consensus.'
The spokeswoman also set out how plans were filtering through to local levels.
'We have asked primary care trusts (PCTs) to draw up local contingency plans which have been audited. This audit has confirmed that most NHS organisations have developed resilient and sustainable contingency arrangements,' she said.
We have also recently issued detailed draft operational guidance to support planning, particularly regarding the provision of care in a community setting.'
At a local level, PCTs and hospital trusts are trying to trade off the costs and benefits of being well prepared.
Jo Webber, deputy policy director at the NHS Confederation, described the plans being put in place as being flexible enough to cope with anything from slightly above normal flu levels to a full-blown epidemic.
But she said: 'It's the logistics that are really tricky. How are you going to keep the service running when half your staff are off ill?'
Ms Webber admitted that although the plans would never be perfect, local health economies were constantly looking at 'nuancing' them.
The published evidence supports what the Govern-ment and NHS bodies say they are doing.
Research in the Lancet in April by Dr Richard Coker, reader in public health medicine at the London School of Hygiene and Tropical Medi-cine, backs the DoH view. He shows that the UK scored 80 per cent on a series of preparedness criteria, putting it at the top of the European table.
But the DoH's draft guidance also shows that a potential attack rate of between 33 and 50 per cent will far outstrip the current capacity of the acute sector to cope. It then sets out ambitious targets to cope, including asking PCTs to provide 28 call handlers per 100,000 population to deal with crisis calls.
From ministers' perspective, this may seem like a sensible precaution, but one source close to the Govern-ment's planning exercise labelled this latter target 'mind-blowingly daft' and questioned whether such a diversion of resources from the front line was sensible.
Whether there is a pandemic remains to be seen, but it's clear that we need to keep assessing our preparedness for a pandemic, and disseminating the guidance effectively.
https://www.dh.gov.uk/PolicyAndGuida...demicFlu/fs/en b
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Posted by Sniffles on P4P
In October last year, the Chief Medical Officer for England warned a pandemic of influenza could kill 50,000 people in Britain, if not this year, then soon. One year on, the threat remains and leading doctors question whether we are doing enough to prepare.
Dr Bruce Taylor, who has advised the Government on flu planning, said given the 37-year cycles of flu, another pandemic is overdue and that we should expect one within three years.
He said good progress had been made with planning for this pandemic, but several issues were still to be resolved. For instance, oxygen manufacturers had guaranteed increased supply, but the logistics and transport could not be guaranteed if, for instance, lorry drivers were struck by flu.
Dr Taylor, a consultant in critical care medicine at Queen Alexandra Hospital, Portsmouth, added that issues such as legal cover for doctors working beyond their competencies in emergency situations needed to be ironed out.
'It makes me worried - for all the work we're doing, it will be a nightmare and we will be faced with really hard choices,' he told Hospital Doctor.
Dr Tony France, an infectious diseases consultant at Ninewells Hospital, Dundee, agrees that there are still serious challenges to come and is concerned that simple issues such as childcare arrangements for nurses could exacerbate an expected 30 per cent absence rate and 'severely strain' the NHS.
From one GP's perspective, inadequate communication has been a major concern. Dr Simon Stockley, a member of the Government's joint working group on pandemic flu, who practises in Teesside, said: 'GPs are still unsure of what is required of them and are unsure of what plans are being put in place. People on the front line have only a small amount of knowledge of what's being planned.'
Despite these concerns about preparedness, the DoH is taking the threat seriously. Stockpiles of 14.6 million courses of antivirals - enough to treat the quarter of the population expected to fall ill - are due to be completed later this month. But draft DoH guidance seen by Hospital Doctor suggests this 25 per cent 'attack rate' may be a best-case scenario.
A DoH spokeswoman said: 'A flu pandemic could be very serious. It makes sense for the UK to be as prepared as we can be. Preparation for a pandemic is ongoing and we are constantly reviewing and developing our plans in light of emerging information and international consensus.'
The spokeswoman also set out how plans were filtering through to local levels.
'We have asked primary care trusts (PCTs) to draw up local contingency plans which have been audited. This audit has confirmed that most NHS organisations have developed resilient and sustainable contingency arrangements,' she said.
We have also recently issued detailed draft operational guidance to support planning, particularly regarding the provision of care in a community setting.'
At a local level, PCTs and hospital trusts are trying to trade off the costs and benefits of being well prepared.
Jo Webber, deputy policy director at the NHS Confederation, described the plans being put in place as being flexible enough to cope with anything from slightly above normal flu levels to a full-blown epidemic.
But she said: 'It's the logistics that are really tricky. How are you going to keep the service running when half your staff are off ill?'
Ms Webber admitted that although the plans would never be perfect, local health economies were constantly looking at 'nuancing' them.
The published evidence supports what the Govern-ment and NHS bodies say they are doing.
Research in the Lancet in April by Dr Richard Coker, reader in public health medicine at the London School of Hygiene and Tropical Medi-cine, backs the DoH view. He shows that the UK scored 80 per cent on a series of preparedness criteria, putting it at the top of the European table.
But the DoH's draft guidance also shows that a potential attack rate of between 33 and 50 per cent will far outstrip the current capacity of the acute sector to cope. It then sets out ambitious targets to cope, including asking PCTs to provide 28 call handlers per 100,000 population to deal with crisis calls.
From ministers' perspective, this may seem like a sensible precaution, but one source close to the Govern-ment's planning exercise labelled this latter target 'mind-blowingly daft' and questioned whether such a diversion of resources from the front line was sensible.
Whether there is a pandemic remains to be seen, but it's clear that we need to keep assessing our preparedness for a pandemic, and disseminating the guidance effectively.
https://www.dh.gov.uk/PolicyAndGuida...demicFlu/fs/en b
_________________
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