Since 2007, we have been expecting a serious Avian flu pandemic, hence the national pandemic flu plan: looks great on paper – and it seems we have a supply of Tamiflu, which I suppose is something!

However, medication is only a small part of planning for any epidemic: there is also identification of cases, treatment of patients, managing contacts and preventing spread, distribution of protective clothing, viral swabs, medication and above all, a local co-ordinated action plan which can be implemented when needed.

So what happened when we got swine flu?

Very few of the systems needed for pandemic flu planning are in place: the Flu Help Line (in GP plans as the first point of contact for the public) not expected for another 6 months: no clarity as to the supply of protective clothing for front-line staff (the whole plan will be in trouble if they catch flu!): a single phone number to contact the HPU (Health Protection Unit) responsible for sending out viral swabs, and managing the supply of Tamiflu and no clear plans for managing patients too ill to manage at home without support or available for outbreak control.

What is the advice? Naturally, “Call NHS Direct or your GP”!

There seems to be differing degrees of chaos round the country: some GPs have been told to buy their own protective clothing: some lucky practices have received as many as 48 masks. Some areas are telling GPs to visit (with or without protective clothing) – and then visit again to take swabs if the HPU decides the case might be flu and sends over viral swabs: I have not managed to find anywhere with effective planning – and despite the GPC castigating GPs who haven’t managed to organise flu plans in the absence of PCT-wide plans, planning for pandemic flu does extend far beyond individual practices!

All I can say is, we’re very lucky this is swine – and not avian – flu this time.

How soon will our luck run out?