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‘Sleeping contract’ for GPs needed to prevent future flu pandemic delays

By Steve Nowottny

Preliminary talks on a ‘sleeping contract' to pay GPs during a future flu pandemic are already underway, and are essential to prevent delays in vaccinating patients, an independent report into the swine flu outbreak said yesterday.

The review into the UK's strategic response to last year's pandemic, led by Dame Deidre Hine, revealed that the Government's response to swine flu had cost £1.2bn – but added that this had been on the whole been ‘proportionate and effective'.

But it also outlined a series of recommendations to improve a future response, with the protracted negotiations over payment for the swine flu vaccination campaign, at firstly a national and then a local level, coming in for particular criticism.

The report concluded: ‘Negotiations for vaccine administration by GPs were ultimately successful; however, I heard that undertaking them during a pandemic was time-consuming and complex.'

‘Ministers, officials and negotiators were involved throughout the negotiations, which took individuals away from other work they could have been progressing. The process of holding negotiations during a pandemic, although ultimately achieving agreement, did not reflect well on either the GPC or DH.'

The report added that drawn-out PCT-level negotiations over the vaccination of healthy children under fine, which began in December, had been singled out by a number of sources as having delayed the vaccination of children.

The report called for a ‘sleeping contract' to be negotiated with GPs and other providers such as community pharmacists in advance of a future pandemic.

‘A sleeping contract would allow difficult negotiations to be undertaken in a more reasonable timeframe than is possible during a pandemic and could set out: the costs of delivering a pandemic response, including a vaccination programme; the responsibilities of both the Government and GPs; and a clear trigger for when the programme would be both stood up and stood down.'

‘I understand that preliminary discussions on such a sleeping contract are already taking place.'

Dame Deidre said: 'On the whole, the UK-wide response to swine flu was impressive. Wide-ranging preparations and the hard work and dedication of healthcare professionals across the country was instrumental to its success.'

'However there are important lessons to learn for the response to future pandemics.'

Swine flu vaccination was delayed by contract negotiations, the report concludes Swine flu vaccination was delayed by contract negotiations, the report concludes Counting the cost of swine flu


Pharmaceuticals - £506.32m
Consumables (eg facemasks) - £113.1m
Infrastructure (eg National Pandemic Flu Service) – £27.73m


Pharmaceuticals - £505.42m
Consumables (eg facemasks) - £2.3m
Infrastructure (eg National Pandemic Flu Service) - £65.74m
Communications - £15.72m

Total - £1,242m


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