The Secretary of State for Health meets regularly with the NHS chief executive and the NHS flu resilience director, who are responsible for ensuring the national health service is prepared for a swine flu outbreak.
On 2 July, the national director for NHS flu resilience, Ian Dalton, wrote to all NHS chief executives to make clear the expectation that preparedness plans need to be reviewed and subjected to further testing.
To further support local planning, on 10 September, a strategy for critical care services was published that sets out how ventilated critical care capacity can be increased in the NHS during the peak weeks of a potential second wave of swine flu. The published full critical care strategy sets out how the NHS will collectively achieve this increase. A copy has been placed in the Library.
On 10 September, the national director for pandemic influenza preparedness, Lindsey Davies, also hosted a pandemic flu conference on the theme of “Looking back, moving forward”. The conference, attended by 375 delegates, was open to strategic health authorities, primary care trusts and local authority representatives with health and social care responsibilities. The focus of the day was on the swine flu response to date, delivering the swine flu vaccination programme, the challenges that lie ahead and sharing best practice.
The Civil Contingencies Committee has been meeting regularly since the swine flu outbreak, and is chaired by the Secretary of State for Health. The Department for Culture, Media and Sport attends these meetings at which all elements of the Government's response to the swine influenza pandemic are discussed.
Throughout the outbreak, the Government have provided a wide range of advice to businesses generally about the impacts swine flu could have on them, through mechanisms such as the Business Advisory Network on Flu and the BusinessLink website. Planning assumptions have been issued which are of use to all sectors.
We are now relying on clinical diagnosis instead of laboratory confirmation to identify cases of swine flu.
The rates of general practitioner (GP) consultations for influenza—like illness from a sample of participating GP practices is used to identify epidemic levels of swine flu activity in an area.
The current criteria used to define the level of flu activity are:
Baseline (outside of a normal flu season) activity (<30 GP consultations per 100,000) during a week;
Normal seasonal activity (30-200 GP consultations per 100,000) during a week; and
Epidemic activity (>200 GP consultations per 100,000 people) during a week.
Strategic health authorities that experienced levels of above 200 GP consultations per 100,000 population over the summer of 2009 are:
London;
North East;
East Midlands;
North West;
West Midlands;
South West; and
South East Coast.
As of 5 pm 25 September 2009, around 1.3 million calls to the information line were received.
Up to 30 September, the Department has spent around £230,000 on the provision of the service.
Based on advice from the Joint Committee on Vaccination and Immunisation, the following groups will be the first to be vaccinated with H1N1 swine flu vaccine, in the following order:
individuals aged between six months and up to 65 years in the current seasonal flu vaccine clinical at-risk groups;
all pregnant women, subject to licensing conditions on trimesters;
household contacts of immuno-compromised individuals; and
people aged 65 years and over in the current seasonal flu vaccine clinical at-risk groups.
In addition to this, front line health and social care workers will be offered the vaccine at the same time as the first clinical at risk groups as they are at increased risk of infection and of transmitting that infection to susceptible patients.
The Health Protection Agency has worked with independent academic experts to analyse the impact of the containment policy on the spread of the virus in the United Kingdom. This work has been submitted for publication and a copy of the publication will be placed in the Library when it is available.
The Health Protection Agency is also conducting a full review of the containment phase that is expected to be completed in early 2010.
(2) how many courses of antivirals have been dispensed for the treatment of patients with swine flu in each (a) age group and (b) primary care trust since 2 July 2009;
(3) pursuant to the answer of 16 July 2009, Official Report, column 671W, on swine flu, what the additional antiviral collection point functionality added to the flu line service is;
(4) what the differences are between the full National Pandemic Flu Line Service and the interim solution.
The interim National Pandemic Flu Service (NPFS) launched with 1,500 concurrent seats from seven call centre operators, operating from 19 sites across the United Kingdom. Over 3,500 agents were initially trained to provide the service. The agents are employed by a range of private and public sector call centre operators to ensure that the service can flexibly operate seat and agent supply to meet public demand.
The service is capable of operating 7,500 concurrent call centre seats. This level of operation, if required, would enable around 1 million calls in a 24 hour period to be handled by call centre operators in addition to those using the web service.
From the launch of the interim NPFS on 23 July 2009 to 29 September 2009, around 590,000 antivirals were dispensed for treatment of patients. The breakdown by age group and primary care trust has been placed in the Library.
These figures relate solely to antivirals collected through the NPFS, as antivirals distributed between 2-22 July 2009 were distributed through normal primary care routes and by the Health Protection Agency; those data are still being collated.
The antiviral collection point system that has been developed enables members of staff in collection points to:
check the validity of an authorisation number generated by the NPFS;
check and confirm the name of the patient and the antiviral and dose authorised;
check that the authorisation number has not been used previously to collect an antiviral;
record the checking of identification (ID), and types of ID provided by the flu friend for themselves and the patient;
record the details of the flu friend who has collected the antiviral;
record the collection of the antiviral to prevent the authorisation number being used more than once; and
provide regular information on the number of antivirals issued using an authorisation number.
The autumn solution (i.e. full NPFS) does have increased functionality and offers a more flexible information technology platform.
Individuals who use the service will follow a very similar process to the current service. The main change from an individual's perspective is the additional ID functionality. An overview of additional functionality is as follows:
a dynamic algorithm will provide greater flexibility if the algorithm needs to be changed and enables changes to be processed more quickly;
an enhanced ID process: identification can be verified during the assessment as well as at the collection point;
the functionality to re-issue an authorisation number through NPFS will be available to enable patients who forget their authorisation number to re-contact the service quickly and efficiently to access a new number that can be used in an antiviral collection point; and
the autumn service is planned to offer additional languages on the web.
The primary care trusts (PCTs) that reported exceptional levels of flu like illness are:
Tower Hamlets PCT
Greenwich Teaching PCT
Islington PCT
Lewisham PCT
Leicester City PCT
Barking and Dagenham PCT
Harrow PCT
Bedfordshire PCT
Coventry Teaching PCT
Middlesbrough PCT
South Tyneside PCT
City and Hackney Teaching PCT
Telford and Wrekin PCT
Redbridge PCT
South Birmingham PCT
Hillingdon PCT
Sutton and Merton PCT
Lambeth PCT
Camden PCT
Warrington PCT
Buckinghamshire PCT
Enfield PCT
Brent Teaching PCT
Blackburn with Darwen PCT
County Durham PCT
East Sussex Downs and Weald PCT
Manchester PCT
Newham PCT
Gateshead PCT
Northumberland Care Trust
South Staffordshire PCT
Sunderland Teaching PCT
West Kent PCT
Peterborough PCT
Southwark PCT
Ealing PCT
Havering PCT
Portsmouth City Teaching PCT
Somerset PCT
Blackpool PCT
North Tyneside PCT
Redcar and Cleveland PCT
Halton and St. Helens PCT
Nottinghamshire County PCT
Luton PCT
Warwickshire PCT
Nottingham City PCT
Oxfordshire PCT
Swindon PCT
Gloucestershire PCT
Hammersmith and Fulham PCT
Heywood, Middleton and Rochdale PCT
Brighton and Hove City PCT
Medway PCT
Leicestershire County and Rutland PCT
Kingston PCT
Unclassified
Central Lancashire PCT
Wandsworth PCT
Solihull Care Trust
West Hertfordshire PCT
Herefordshire PCT
Stockport PCT
Shropshire County PCT
Bromley PCT
Northamptonshire PCT
Cambridgeshire PCT
North Lancashire PCT
Bristol PCT
Derby City PCT
Westminster PCT
Eastern and Coastal Kent PCT
Wakefield District PCT
Southampton City PCT
Western Cheshire PCT
Suffolk PCT
Barnet PCT
South Gloucestershire PCT
Derbyshire County PCT
Waltham Forest PCT
Berkshire West PCT
Hampshire PCT
Newcastle PCT
Worcestershire PCT
Doncaster PCT
Hounslow PCT
East Lancashire PCT
Wirral PCT
Bolton PCT
North Yorkshire and York PCT
Liverpool PCT
Plymouth Teaching PCT
North Somerset PCT
Great Yarmouth and Waveney PCT
East and North Hertfordshire PCT
Croydon PCT
Central and Eastern Cheshire PCT
Lincolnshire PCT
Wolverhampton City PCT
West Sussex PCT
Stoke on Trent PCT
Surrey PCT
West Essex PCT
Knowsley PCT
Leeds PCT
Devon PCT
Norfolk PCT
Sefton PCT
Tameside and Glossop PCT
Milton Keynes PCT
Communicating accurate and timely information to the general public and health care professionals during the current swine flu pandemic has been recognised as a priority by the Department and by the World Health Organisation.
We have communicated regularly via a range of channels including advertising, online information, technical and professional guidance and media briefing, including by Ministers, senior officials and clinicians.
Because of this, it is not possible to quantify accurately the cost of all this activity in producing information on swine flu, however we are able to give a figure for public advertising activity.
The cost of advertising and publicity activity in England on swine influenza, including the Swine Flu Information Phone Line, is approximately £8.2 million to date.
This may increase over the course of the pandemic. Various scenarios are being considered to allow a flexible response if swine flu escalates to ensure that the public have timely and accurate information about the disease, how to protect against it, and how to access treatment if they catch it.
The Department has asked primary care trusts and strategic health authorities to work with local national health service stakeholders to develop local plans to ensure that all of those identified in the Chief Medical Officer’s list of high priority groups receive their swine flu vaccinations. These plans should include provision for housebound patients.
The Department will be supporting this work by providing core materials about swine flu vaccination for staff training and communications with the public and NHS staff.