In his weekly update for HSJ and Nursing Times, national director for NHS flu resilience Ian Dalton discusses the latest developments in UK swine flu preparations

What should NHS staff be focusing their efforts on?

The number of cases of swine flu has risen again this week, with 78,000 cases. The number of patients in hospital with swine flu continues to rise, with the number in critical care rising rapidly. There are now significantly more people in critical care than at any point during the first wave. This is a worrying trend, and is a stark reminder of the threat that that the virus still poses to the NHS and to patients. 

With this in mind, our swine flu vaccination programme takes on added importance.  I have always said that a key part of our resilience will be the success of our vaccination programme and I have written on numerous occasions about the importance of running an effective staff and patient vaccination programme.

Following the successful first deliveries of the swine flu vaccine into acute trusts last week, deliveries have commenced this week to GP surgeries, as well as ambulance trusts, primary care trusts and mental health trusts.

Deliveries to GPs will enable the vaccination of patients in the priority groups to begin.  While the supplies of the vaccine are dependent on the biological manufacturing process, and our timescales therefore remain subject to change, the process of delivering initial supplies to all GP surgeries is likely to take around three to four weeks.

The next steps

The start of the vaccination programme has been a huge logistical effort for the NHS, the likes of which we have not experienced in the recent past, and people should be commended for their hard work. But we must not take our eye off the ball. All NHS organisations should continue to ensure that as high a proportion as possible of eligible staff and clinically at-risk groups are vaccinated. Figures show that of the people who have died as a result of swine flu so far in this country, around two-thirds were in the priority groups for vaccination, and therefore would have been eligible for the vaccine. This figure alone highlights the potential of the vaccination programme to save lives.

A campaign centred on the message ‘if you can’t catch it, you can’t pass it on’ is being run across the NHS to ensure that staff appreciate the importance of getting vaccinated, and a range of materials have been made available for use by senior managers and clinical leaders to engage staff. 

As we begin to feel the additional pressures of winter, we must continue with our whole system approach to managing this pandemic, and broaden this to include wider winter management. The whole NHS has a role to play, and we should give particular attention now to those areas that we know will come under greatest pressure: primary care, paediatric and adult critical care, ambulances and A&E. To this end, we have already increased the number of respiratory ECMO beds available in England.  We have increased capacity at the existing ECMO centre at Glenfield, and have added further beds at Papworth and Brompton.  A total of 29 people with swine flu have required ECMO treatment since the pandemic began, and by increasing capacity we will be able to ensure that we can keep treating those who are most seriously ill.

Progress to date

All the latest information on the current increase in numbers of flu-like illnesses, GP consultation rates, hospitalisations and deaths can be found on the HPA website.

The most up-to-date clinical information and guidance can be found on the Department of Health website at