Chris Lancelot: DoH has worsened swine flu crisis for practices

To observe the inconsistencies within the DoH, look at its handling of swine flu.

Globally, within six months of identifying this new, potentially lethal disease, we have a vaccine. What a triumph of medical and pharmaceutical professionalism.

Contrast that with the DoH's handling of the crisis. Initially, the Health Protection Agency acted with commendable rapidity, but then things went downhill. Despite new instructions being issued every other day, many key questions were addressed late or not at all. New Read codes took six months to produce (the set is still incomplete) and no one thought to change the certification regulations until several months had elapsed.

The immunisation programme could not have been made more complicated. Searching for patients to call in has been a nightmare, made worse because the rules change daily.

Pandemrix has to be made up. Why insist that only the person doing the preparation can give injections from that vial? It means another practitioner cannot use it up - what a waste. Vaccination material is at a premium and once prepared degrades quickly: so why did the DoH order it in 10-dose vials?

Thousands of doses must have been wasted as a result. And why send 500 doses to each practice, irrespective of list size?

Then the training. Many PCTs insisted that everyone giving the vaccine should go on a half-day course. How untrusting can you be? This rigmarole seems to have been created solely to protect managers, without thought of its impact on hard-pressed practices.

What should have happened? Once swine flu emerged, dedicated teams should have assessed potential cases. A complete set of Read codes should have been available within two weeks, certification regulations changed within 24 hours and knowledge about swine flu posted on a single DoH website rather than being disseminated on paper or through multiple emails.

The DoH should have commissioned a standard recall package for each of the major practice computer systems, thus ensuring a uniform immunisation programme and minimal disturbance to administration.

Swine flu has stressed practices hugely. Sadly, DoH management has significantly worsened this stress rather than ameliorated it. Typical, isn't it?

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