The NHS is working to tight deadlines to plan for another wave of swine flu - and estimate how much the outbreak will cost.

PCTs have been asked by the Department of Health to predict how much they will spend during 2009-10 responding to the outbreak. Early figures seen by HSJ are between £1m and £2.2m for each PCT – resulting in a potential maximum of more than £300m.

Estimates are being produced alongside planning for another wave of the infection during autumn and winter. Costs include equipping and running antiviral collection points, extra staff time, additional capacity to respond to surges and running a vaccination programme.

PCTs and providers have been asked to bring details to a board meeting by the end of September. Some strategic health authorities have asked for the plans to be submitted to them by the same deadline, or earlier.

NHS London head of emergency preparedness Andy Wapling said they should combine winter planning with expected demand from swine flu.

He said this would be a significant challenge particularly for intensive care services, which came under pressure each winter. The SHA is arranging for intensive care specialists to be trained to work in children’s intensive care.

It has told organisations to submit plans by the end of September, which it will subject to “real critical analysis”. It will look at different scenarios with organisations at a region-wide event. Mr Wapling said: “We are taking the time for a breather to concentrate on looking forward.”

NHS North East said it would was meeting with PCTs and trusts during August and early September to discuss planning and scenarios.

A spokeswoman said: “This stress testing involves a range of NHS services agreed by the participating organisation and the SHA, followed by a structured debrief with the executive team and with feedback provided to all other players.”

A spokesman for NHS South Central said it had met with PCTs which were leading on swine flu to discuss planning for the next phase. It did not give a deadline. NHS North West said it was working with PCTs and trusts to test plans but did not have a deadline.

Southwark primary care trust director of public health Ann Marie Connolly said a fall in cases and the introduction of the national pandemic flu service had reduced pressure on GPs and the PCT.

However, she said producing complex plans and cost estimates during the summer was difficult.

Dr Connolly said: “The difficulty is doing all this alongside the day job and planning for budgetary challenges.”

She said the PCT had begun planning a vaccination programme as far as possible before a DH announcement on how it will be run. It was still estimating costs.

One PCT’s initial estimate seen by HSJ put the cost at “[in] excess of circa £1m”, another said between £1.4m and £2.2m.