NHS is at its managerial worst over swine flu

While the DoH's initial response to swine flu was excellent, its later efforts have been dire.

Let's start with official information. There has been masses of it (changing daily and sometimes self-contradictory), repeatedly telling GPs how the government's plans were 'the right thing to do' - whilst omitting important information such as: how long do patients remain infectious? What are the signs of deterioration? What precisely is the danger to pregnant women, and in which trimester? Can we legally sign a Med 3 or 5 following a phone or internet diagnosis?

Vital information often came not from the government but via the media. Our practice wasn't officially informed that the National Flu Helpline was open until four days afterwards. My practice manager only discovered that swine flu immunisation requires two injections (rather important for forward planning don't you think?) - from the BBC. And has anyone told you officially that the vaccine will come not in single dose units but vials, taking more time to draw up and requiring longer immunisation appointments? Probably not.

Where are the Read codes? An emergency set should have been issued - for 'Swine flu', 'Possible swine flu', 'Swine flu excluded', 'Swine flu anxiety', 'Tamiflu voucher issued'... And talking of vouchers, each PCT had a different version: none of them electronic.

What about the pharmacy collection points? Why were only some chemists designated? Their scarcity led to some sites being overwhelmed by the demand while people living in country areas were often forced to travel unacceptably long distances.

Why were the locations of the distribution centres initially kept secret - even from GPs, in some cases? And haven't NHS managers realised that having collection points separate from chemists means concomitant prescribing is more difficult?

Finally, why bother with stringent identity checks and guards at collection points, coupled with massive anti-fraud measures involving the design, use and storage of the vouchers, when it is child's play to fool the helpline into issuing them in the first place?

This is abysmal - the NHS at its managerial worst: an object lesson in causing chaos. Be grateful it's only H1N1 we're dealing with, not avian flu or SARS.

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