Former CMO for Wales Dame Deirdre Hine's review into the UK's response to swine flu said that undertaking negotiations with GPs on vaccination had been 'time-consuming and complex'.

'The process of holding negotiations during a pandemic, although ultimately achieving agreement, did not reflect well on the GPC or DoH,' she said.

Dame Deirdre said that many contributors to her review called for sleeping contracts for vaccination services with GPs or other willing providers, such as community pharmacists.

Contracts should be drawn up with the four UK governments, she said. 'A sleeping contract allows difficult negotiations to be undertaken in a more reasonable timeframe than is possible during a pandemic,' she said.

The deals could set out the costs of a response, including vaccination, GPs' duties and a clear trigger for when work would begin and end, she said.

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