Primary care trusts have been ordered to “test to destruction” their plans to deal with swine flu amid concerns that some may be complacent about their preparedness.

The Department of Health has cranked up its message to the service, with health secretary Andy Burnham and NHS chief executive David Nicholson both stressing the need to be ready as the number of cases in the UK and elsewhere in the world rose last week.

Mr Nicholson said a significant outbreak was likely this year and the NHS “getting its act together” was vital.

National director for flu resilience Ian Dalton called PCTs to a private meeting about their swine flu plans, hours before the World Health Organisation declared a pandemic.

The flu czar warned PCT managers they should be “testing their plans to destruction”. HSJ understands there are concerns that plans could “fall apart”.

One source at the meeting told HSJ: “The subliminal message was ‘we’re not convinced everyone is taking it seriously’. “If some places cope and others are found wanting, be clear you’ll be held to account for it.”

Human resources issues, such as whether PCTs had planned for staff shortages, whether staff knew what to do if not enough drugs were available, and GP provision were of particular concern, the source said.

NHS Confederation PCT Network director David Stout said PCTs were “reasonably confident” about their plans.

“I’m not picking up a real major concern [from PCTs] but as the prospect of fairly serious demand grows people are going to have to look again.”

He said the confederation’s own polling of PCTs and hospitals had found them to be largely confident plans were robust.

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Flu preparations

All PCTs should have:

  • Pandemic influenza co-ordinator in place
  • Strategy for co-ordination with local authority, acute trust and SHA
  • Strategy to communicate with public and local business
  • Contingency plan for distributing vaccinations
  • Plan to mobilise general practice and other primary care resources