No National Flu Line until autumn

Tags: AIM Alert BT Contract Darzi DH Flu line Government GP Medicines NHS Direct Pandemic Swine flu website

29 Apr 2009

A telephone and web-based National Flu Line service to offer advice and authorise access to antiviral medicines in the event of a pandemic will not be ready until the autumn, the Department of Health has admitted.

The service is still being created, even though it was first included in a Cabinet Office/DH framework for responding to a pandemic published in 2007.

The National Flu Line has also been flagged as the main route for getting advice and antiviral drugs to the public in subsequent advice to primary care planners and GPs, with different documents saying it will be activated at World Health Organisation pandemic alert phase four or five.

On Monday, the WHO raised its pandemic alert level to phase four after confirming outbreaks of swine flu in Mexico, the US and Canada.

Phase four indicates human-to-human spread of a virus while phase five indicates human-to-human spread of the virus into at least two countries in one region. Phase six indicates a global pandemic with widespread outbreaks.

On the same day that the WHO moved to phase four, health minister Lord Darzi told the House of Lords that the DH had signed a contract with BT to set up the National Flu Line, but anticipated that it would not be ready until the autumn.

He added: “Lest we forget, most pandemics occur in waves, as we saw in Spanish flu, which was in three waves. Obviously, we are focusing all our efforts on ensuring that the line is available in the autumn.

“Through the NHS Operating Framework, we have also ensured that the NHS is ready to deal with such a situation. NHS Direct and all primary care trusts are looking at the options in which they could release the stockpile of antivirals if such a need arises.”

In its November 2007 framework, the government said the flu line would be activated at WHO phase five, providing advice, updated information and access to literature.

At WHO phase six the service was intended to expand to provide rapid assessment and where necessary access to antiviral treatment for symptomatic patients.

Subsequent documents, including advice issued recently by the British Medical Association and the Royal College of General Practitioners, has indicated that the flu line will be available from phase four to provide advice. This guidance says that from phase six it will be the “only route for patients to access antiviral drugs.”

Patients are supposed to get authorisation from flu line for the drugs and then send a ‘flu friend’ to an approved pick-up point to collect them. The aim is to keep infected people at home if possible.

A statement issued by the DH this week said: “Since agreeing a contract in December 2008, we’ve been working extremely hard with BT to get the flu line system up and running as quickly as possible.

“However, this is a ground-breaking approach to authorising antivirals and it would be too risky to introduce it without full development and testing, which is why we need more time to get it right.”

With or without the National Flu Line, all local health agencies have strong plans in place to distribute antivirals in a timely and efficient manner – and, as the World Health Organisation has said, we're one of the best-prepared countries in the world for dealing with a pandemic."

Shadow health minister Stephen O’Brien said the UK could be without a National Flu Line for at least five months after the first cases were confirmed in the country.

He added: “The National Flu Line will be crucial if a pandemic were to happen in Britain, by allowing people to get the information and the antivirals they will need to fight the flu without having to go to GP surgeries or hospitals.”

“It is absolutely imperative that the Government takes action quickly to ensure that it is able to deal with the high numbers of calls from people who will need help should the (swine flu) virus spread in the UK.”

Last year ministers said that NHS Direct would taking a lead role on the Flu Line and board papers for the end of April show that technical specifications have been agreed and signed off but that all call centre agreements are not due to be in place until the end of the year.

This week NHS Direct said that it began receiving calls about swine flu on Sunday, with 88 calls that day and 1,378 on Monday out of total calls answered on Monday of 15,039.

On Monday NHS Direct’s website recorded 85,000 visitors, compared to 54,610 for the same day the previous week, with 2,205 uses of its cold and flu self assessment tool compared to 785 uses the previous Monday.

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Reader's Comments

So long as it's ready by the Autumn

29 Apr 09 11:04

It's lucky that we're coming to the end of the flu season. Should any pandemic occur it should now not spread significantly in the northern hemisphere until the Autumn, so as long as all the stops are pulled out to ensure it's in place for the beginning of the flu season, all is not lost.

Oh great!

30 Apr 09 09:04

As a GP, the much vaunted preparedness is looking a little ragged. All paperwork we have received so far assumed the presence of the Flu Line so practices locally have prepared in light of this. NHS Direct is not an alternative as their current protocol simply redirects suspected flu cases back to the GP.

Add to this the poor availablility of viral swabs and masks and the suggestion in my area that GPs are responsible for personally transporting swabs the 30 miles to the lab and I fear the worst.

Overall I feel that the plan is turning into a game of tag and currently GPs are 'it'.

Please don't do a bodged rush job

01 May 09 21:05

Let's hope that the government don't rush out some half baked untested system to meet a politically motivated 'gap' and ride rough-shod over all the local preparations that everyone has been making.

The Open Exeter team have been working on a solution which would tie to the GP Registration databases, but that would be far too sensible and useful to release for use.

A cut down website allowing uncontrolled access to register 'need' would definately not.

Bets on what will get their priority ?

Do the plans consider resources?

02 May 09 10:05

I'm another GP, and locally (in the absence of the flu line) the advice is - obviously - "call your GP - but don't go down to the surgery". So the practices will need to have someone trained to telephone triage flu symptoms (and be accountable for any errors in grading - so a doctor or nurse), then if patient needs to be seen, GP visit to assess/treat, followed by further visit to take swabs provided by HPA: no mention of any resources or support for this. So lets assume that GPs will be among the first occupational group to develop pandemic flu in the first wave, what happens in the second week of the epidemic - or to any patients with less fashionable diseases? I suppose I am better off than the previous poster: we have been promised a courier!