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GPs must 'opt in' to swine flu 'command and control' to protect income

By Steve Nowottny

Practices have been warned they will have to opt in to a military-style ‘command and control' system to qualify for income protection as the swine flu pandemic escalates.

A PCT briefing document obtained by Pulse details how command and control, agreed in principle by the GPC and RCGP last year, will work in practice if the pandemic worsens. Under the arrangements, practices will be effectively employed by trusts, which will centrally control resources.

A joint circular from NHS Derbyshire County and NHS Derby City advises practices: ‘By opting in, primary care teams will be subject to a control and command model that is very different to the current independent-contractor status.

‘It will be more closely aligned to an employer-employee model where teams will be directed by those controlling resources. Practices that don't opt in will not receive [income protection] guarantees.'

GP partners will be required to work a minimum 52.5-hour week and could be taken out of their practices and deployed elsewhere, the guidance adds.

The details emerged as the Department of Health unveiled new tactics for combating the swine flu virus in outbreak areas including London, Birmingham and Glasgow.

GPs in ‘hotspots' can now determine cases of swine flu by clinical diagnosis rather than swabbing, which will only be conducted on a small sample of cases for surveillance.

GPs have also been advised to stop offering antivirals to contacts of confirmed cases, but continue to use them to treat all symptomatic patients.

The changes were prompted by a spiralling number of cases. As Pulse went to press, 5,397 cases of swine flu had been confirmed, while a 73-year-old man in Inverclyde, Scotland, and a nine-year-old girl in Birmingham became the UK's second and third swine flu fatalities.

NHS London and NHS West Midlands insisted they had no immediate plans to suspend the QOF or other routine work after the Government's decision – revealed in Pulse last week – to scrap the triggers for suspension set out in its own pandemic plans.

GPC deputy chair Dr Richard Vautrey said talks with the DH on how to bring ‘legal force' to contingency plans were ‘ongoing': ‘Both the DH and ourselves are very aware of the increasing numbers of cases.'

Dr Andrew Mimnagh, chair of Sefton LMC, said practices would be willing to work in a command and control structure, but were ‘suspicious' of being asked to do so without assurances of protection.

Dr Andrew Mimnagh, chair of Sefton LMCDr Andrew Mimnagh, chair of Sefton LMC Dr Andrew Mimnagh

Practices have found past verbal assurances not to be honoured

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