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At the heart of general practice since 1960

Patients demand: do nothing to undermine continuity of care

Many practices may be late starting their flu campaign this year because of delays in

vaccine delivery ­

Dr Jim Sherifi advises on how to run a campaign that is still effective

Annual vaccination against the flu virus for vulnerable groups in the UK has been part of national health policy since the 1980s.

Such groups are defined as:

All those aged 65 and over

All those aged over six months in the following clinical risk groups:

·chronic respiratory disease, including asthma, COPD, emphysema, bronchiectasis, cystic

fibrosis

·chronic heart disease (eg congenital heart disease, hypertension with cardiac complications, chronic heart failure, ischaemic heart disease)

·chronic renal disease (eg chronic renal failure, renal transplant, nephritic syndrome)

·chronic liver disease ­ new indication added for 2005 (eg cirrhosis)

·diabetes mellitus (eg type 1 or type 2 on oral therapy)

·immunosuppression (eg asplenia; HIV infections; chemotherapy; long-term (greater than one month) significant dose {>20mg/dy prednisolone} steroid therapy)

Those living in residential care homes where infection may lead to high morbidity/ mortality

Those who are the main carer for an elderly

or disabled person whose welfare may be at risk if the carer falls ill (new indication added for 2005)

NHS employees directly involved in patient care as well as social care employees working in nursing and care homes should also be offered vaccination by their employers; this service falls outside that provided by the national programme and is therefore funded by the individual employer

New targets

Traditionally, primary care has been effective in implementing this public health policy, where around 70 per cent of the target population has been vaccinated successfully against the influenza virus.

However, WHO has set a target of 85 per cent uptake in all groups by 2010, requiring an accelerated improvement on the past five years where the uptake increased from 65-71 per cent

in England. And there are additional challenges

for 2005.

Jim Sherifi is a GP in Sudbury, Suffolk

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