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Having been involved in a lot of Pandemic Flu planning recently, I would have to agree with the comment above that it is changing directives and information from the DH that is particularly challenging and may mean make or break for some PCTs who are working hard to ensure readiness.
The DH seems to renege decision making when it feels like it, leaving things to 'local decision making', only to then change their mind a few days later.
What concerns me is that Trusts are still waiting for the 'national' panedmic flu system which, as we still havent had it, we are planning to be without and have spent a lot of time, blood, sweat and tears creating alternatives for. If this system suddenly appears at the same time the situation deteriorates, it will potentially undo many of the local plans put in place to date, or change the decisions upon which these systems have been made and make PCTs fail due to no fault of their own.