England's flu czar has defended the use of a swine flu hotline in the face of claims that serious illnesses will be missed as patients are assessed over the phone.
Nine out of out 10 GPs believe that diagnosing flu over the phone will mean other diseases may be missed, a GP survey of 251 GPs has found.
Asked about these concerns in an exclusive interview, Ian Dalton, England's director of NHS flu resilience, said the clinical algorithm used for the pandemic flu service was planned on a 'precautionary principle'.
'The algorithm has been designed in such a way that, as best as we can predict, people who have serious conditions, be that meningitis or MI, or anything else, will be taken to the point of need,' he said.
He added the advantage of an algorithm was that it was 'intrinsically appropriate' to use non-clinically qualified people to operate it. 'We're not asking those people to exercise clinical judgment - that's what GPs do,' Mr Dalton said.
Mr Dalton praised the 'fantastic response' of GPs. 'We always expect the best of our GPs and we've certainly not been disappointed,' he said.
'I know that the number of consultations, the out-of-hours calls and the telephone contacts have required GPs to work very, very hard. I think they've responded magnificently.'
GPs have acknowledged that the hotline has relieved the pressure on them. Our survey found that most have seen their swine flu-related workload fall since the pandemic flu service was introduced, although a third have seen no reduction in work.
In addition, most GPs want to see specialist flu centres introduced, to assess patients and provide vaccinations. Mr Dalton said that the DoH was not currently working on plans for such centres. 'Our hope is that the vast bulk of people with flu will be treated through the national pandemic flu service,' he said. 'That will save GPs time to see patients who need particular clinical judgment and to deal with any complications of flu.'
However, Mr Dalton is keen to keep 'a close eye' on the pressures on general practice. 'I will be listening and we will be doing all we can to keep primary care acting effectively,' he said.