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Swine flu: counting the cost

For the past four months, as the NHS has single-mindedly focused on swine flu, limiting the spread of the first wave and preparing for the next one, there’s been one nagging question: how much is this all going to cost?

By Steve Nowottny

For the past four months, as the NHS has single-mindedly focused on swine flu, limiting the spread of the first wave and preparing for the next one, there's been one nagging question: how much is this all going to cost?

Various figures have been bandied about. The Department of Health said early on that it had spent £500 million on buying drugs for a potential pandemic – although for commercial confidentiality reasons it declines to break that figure down.

Estimates collected by the Health Service Journal suggested that PCTs could end up spending £300 million between them over the course of the pandemic, although the estimates are at a very early stage and dependant on an almost impossible number of variables.

But today for the first time Pulse reveals not what might be spent but what has already been spent – and it's a not insignificant figure. Between PCTs, the National Pandemic Flu Service, public information campaigns and the antivirals distributed, the total cost is almost £40 million.

Actually, it's probably significantly more than that. There was a long list of costs we weren't able to include, either because we didn't have time to ask for them (what are hospitals spending? how about SHAs?) or because they're simply unknown (costs for late July/August, from the majority of PCTs, for example).

Perhaps most significantly, what wasn't included in our calculations was the cost of paying staff who would normally be working on other things, who have been diverted to swine flu work instead. This includes frontline healthcare workers (and GPs, of course) but it also a vast and uncounted number of auxiliary/administrative staff working throughout the health service.

One example we've noticed, for instance, is that some NHS press officers have been diverted from answering questions from the media to working on public-facing information campaigns to get across key health messages. Some trusts used administrative staff to help with work such as contract tracing in the early stages of the outbreak, while others have asked for volunteers to man Antiviral Collection Points.

Fair enough. In a pandemic situation it's all hands to the pump. But one can only imagine the total number of staff who have been sidetracked, and the projects put on hold.

We don't yet know what the autumn will bring. The consensus seems to be that there will be a second wave of swine flu, and it may be bad – in truth, no one's quite sure. But what the figures we publish today show is that even if swine flu were to disappear completely, it's already had – and will continue to have – a huge impact on a hard-pressed health service. It's been, to put it bluntly, a massive distraction.

When the next set of Operating Frameworks roll around and NHS trusts take stock of how far they've come over the last twelve months on key priorities – World Class Commissioning, access, IT projects – they may find they're counting the cost in more than just financial terms.

By Steve Nowottny

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