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Independents' Day

PCTs 'sitting with their fingers crossed' over swine flu second wave, claims GPC negotiator

By Ian Quinn, Lilian Anekwe

GP leaders fear the financial crisis facing primary care organisations will leave practices abandoned in the places worst hit by the imminent second wave of swine flu.

Dr Dean Marshall, one of the GPC's lead negotiators on pandemic flu, said the ‘worst-case scenario' of swine flu spreading quickly across the UK would cause less long-term damage to practices than if the outbreak is concentrated on certain hotspots.

The first wave of the virus hit particular areas, including Glasgow, Birmingham and London, much harder than the rest of the country.

And Dr Marshall said the impression from many PCTs is that 'a lot are sitting with their fingers crossed hoping it's not going to happen.'

His comments follow a Pulse survey which revealed 56% of GPs believe their NHS locally has not taken appropriate steps to prepare for the next wave.

In an exclusive interview with Pulse, Dr Marshall - who is also chair of GPC Scotland - said: ‘If the second phase spreads very quickly then it won't be a problem. If it gradually rises uniformly across the country at a pretty even level then that solves that problem because at PCT-level normal work will be suspended and we'll bring in an emergency SFE (Statement of Financial Entitlement.) It's if we get hotspots again, that's going to be very difficult.

Dr Marshall said there remained huge question marks over how GPs would be compensated for loss of income from the QOF if routine work is suspended.

Pulse's survey revealed more than half of GPs believe the only way to cope with the additional workload they face will be to suspend elements of routine work.

Dr Marshall said: ‘In one PCT you might have ten per cent of practices overrun and the rest fine; how do you deal with that, and manage that? Suspending normal work is going to be the big problem. What is the trigger to suspend that? At PCT level there will be certain triggers but when you're below that, down on the ground, when individual practices are completely overrun, how do you do that with a national contract and national targets?

As talks continue at a national level about the triggers for QOF suspension by PCTs, Dr Marshall said that while some trusts are well prepared, others are still ‘kidding themselves' a second phase may not happen.

‘A lot of PCTs tell us they are cash-strapped and have a lot of initiatives going - we've got to say to them "there's a good chance this is going to happen".'

'It's fine to discuss that at national level but then when LMCs go into their local trust they get a mixed response.'

However responding to Dr Marshall's comment, a Department of Health spokesperson denied that PCTs were unprepared for a second wave of the pandemic.

'Every single part of the NHS has been building on their already robust plans to tackle the pandemic,' she told Pulse. 'At this very moment, these plans are in the final stages of stress testing, and we're confident that PCTs will rise to the challenges that a second wave could bring. Of course, if the second wave never comes, that would be better for everyone - but the NHS is rightly prepared for it.'

Dr Dean Marshall: many PCTs have their 'fingers crossed' Dr Dean Marshall: many PCTs have their 'fingers crossed' Interview: Dr Dean Marshall

The full interview

Read the full interview with Dr Dean Marshall exclusively online at PulseToday on Thursday 1 October.

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