GPs in England were told yesterday how to prepare for and operate during a flu pandemic: similar instructions for practitioners in the rest of the UK will follow shortly.

The new guidance was issued jointly by the British Medical Association (BMA) and the Royal College of General Practitioners (RCGP), with the support of the Department of Health in England, on Wednesday. A full copy of the 61-page guide, which is described as a “live” document (ie GPs should keep returning for updates) can be downloaded from the BMA website.

Many health experts believe we are overdue for another pandemic; there have been three in the last hundred years, but it’s not possible to say exactly when the next one will arrive.

The new guide is intended as a practical document for practitioners and practice managers. It recommends general practices take sensible steps and prepare now, to ensure that a maximum number of lives are saved instead of trying to struggle with a “getting through” approach. It warns that a pandemic would put the NHS under “unprecedented pressure” and general practice would be “stretched beyond its current limits”.

The document says that the average GP surgery is likely to see an average of 186 extra cases a week when the current flu outbreak reaches its peak.

The guide explains how GP surgeries should operate during a pandemic, for instance they will be expected to:

  • Respond robustly by following “command and control” arrangements co-ordinated and monitored through Primary Care Trusts.
  • “Buddy up” with neighbouring practices to share resources and swap staff, as necessary. These fallback arrangement should be in place by the end of March.
  • Minimize the spread of infection by doing things like putting patients with flu in a separate waiting area.

The guide also explains how:

  • Retired doctors will be called upon to ease pressure on local services, for example for signing off death certificates.
  • Flu patients will have direct access to antiviral medicine via a new National Pandemic Flu Line Service, and not via their GP surgery.
  • Health service capacity will be freed up by re-prioritizing services and patients, systematically and ethically.

Dr Laurence Buckman, Chairman of the BMA’s GP Committee, said that over the Christmas season we have seen how seasonal pressures put strain on the health service: but the system is operating normally. A flu pandemic is a major emegency where the NHS would have to work differently:

“Family doctors need to be prepared for this and this guidance has been produced to help them with their planning,” said Buckman in a press statement.

“During a pandemic many people will get flu and a few will be very poorly, but there will still be people suffering from other illnesses and they will also need our full attention,” he explained, adding that “plans are being put in place now to make sure general practice and the health service not only copes during the crisis, but does the best it can do to minimise the spread and impact of a flu pandemic in the UK.”

Dr Maureen Baker, Honorary Secretary at the RCGP said:

“General Practice is a critically important service which needs to be able to function as well as possible during a flu pandemic.”

“This guidance provides practices with clear instructions on the steps they need to take now and during the pandemic, so that they can look after people with flu, and other emergencies, as well as can be done in very difficult circumstances,” she added.

Though it is not possible to predict the timing or the severity of a pandemic, experts suggest that up to half of the population of the UK (about 30 million people) could catch flu during one. Most people would be expected to treat themselves at home, but up to one third of those may need to be assessed and treated by their GP and about 4 per cent are expected to be admitted to hospital, usually because of bronchitis that could turn into pneumonia.

“Preparing for pandemic influenza. Guidance for GP practices. What to do now and in a pandemic.”
Royal College of General Practitioners and British Medical Association’s General Practitioners Committee.
Produced by COI, December 2008.

Click here for more information and to download the full guide (PDF).

Sources: BMA.

Written by: Catharine Paddock, PhD