Primary care trusts must be prepared to pick up the tab for extra GP services during an escalation of the swine flu pandemic, the Department of Health has warned.

Guidance published last week says locums may need to be sent in or patients redirected to other sites, such as health centres, when GPs are off sick. Additionally practices should be matched to “buddy” practices who can take over if one surgery is forced to close.

However, the guidance warns PCTs that they should not withhold money from GPs for the time they are closed and they will also have to pay buddy practices for taking on the extra work.

Additionally, the document says GPs should be freed-up by cancelling less urgent services such as obesity management and non-clinical tasks such as reporting and practice based commissioning work.

It says the DH will continue to review whether to suspend performance-related elements of GP pay, such as the quality and outcomes framework, during a further escalation of the pandemic. However, it reveals this may be done on an area-by-area basis, rather than nationally, depending on pressure on services.

NHS Tower Hamlets medical director Douglas Russell said the PCT was planning to contract additional GPs to be available to work in the area if necessary, despite the potentially unnecessary extra cost. It was hoped network arrangements, already formed between some practices to better co-ordinate services, would be used to offer backup where needed.

Dr Russell said the PCT had considered planning for suspending elements of the GP contract and selected services, but concluded the decisions were better taken by the DH. He said: “We decided it was better not to risk having a mosaic of differences across London.”