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Don’t waste the calm before the second swine flu wave

With the first wave looking like it has peaked, there may be a breather before the autumn onslaught – but there is much to be sorted out before it hits

With the first wave looking like it has peaked, there may be a breather before the autumn onslaught – but there is much to be sorted out before it hits

Swine flu? What swine flu? The early indications are that the virus has peaked, for now at least. Cases are levelling, consultations may even be slightly down and some of the more apocalyptic predictions for the spread of the illness look unlikely to become reality. Until the autumn, that is. Because it won't be until the leaves start falling and the UK starts shivering that swine flu will really get going.

All of which buys GPs, and ministers, a little time – a breather before a seriously tough flu season. It's essential that the Government uses that time wisely, by equipping practices properly to cope with the expected surge in workload, and finding new ways to relieve the pressure on GP resources.

Take the sick note system. The Department of Health's new flu line has eased the burden on GPs to some degree, but patients are still phoning surgeries in large numbers to get signed off from work. Ministers had considered waiving the need for a sick note

in patients off work for two weeks or less during the swine flu pandemic, but they backed down, supposedly after pressure from employers. They should not have done so – because now GPs are in the ridiculous position of having to write a sick note based on little more than the patient's word. Rarely has a policy bungle summed up the term ‘defeating the object' quite so succinctly.

Then there's access to antivirals. Handing them out to anyone with a sniffle and a temperature may be a generous gesture on the behalf of the DH, but there are serious questions over whether it is necessary, sensible or even safe. Barely trained phone operators are handing out a prescription-only drug as though it was a wartime ration of bread and milk – irrespective of the severity of illness or patients' risk status. Nausea and nightmares may not be the nastiest of side-effects, but then swine flu hardly has the nastiest set of symptoms in most patients, either. Would a new policy, in which antivirals were limited to those at the higher end of the risk scale, not be more sensible?

Finally, it is essential the DH properly resources GPs for the coming vaccination programme. Here time really is of the essence, because GPs should be planning their flu clinics now. As Pulse reveals this week, the planned priority groups for swine flu vaccination look nothing like those for the seasonal flu campaign – dashing any hopes that the two could be combined in a single set of flu clinics. Twice the number of clinics means twice the planning, twice the staff and twice the time pressure. The Government must then give GPs twice the resources – particularly as it has resisted all calls to help out practices by suspending the QOF.

GPs will bear the brunt of the swine flu surge this autumn and are quite capable of doing so – but the Government must be a help, and not a hindrance.


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