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?

We have seen another significant drop in the number of swine flu cases, with the HPA estimating that last week there were 11,000 new cases in England. We have also seen a decrease in the number of people contacting the national pandemic flu service and hospital admissions also appear to be going down.

However, as we’ve said in the past, although swine flu is mild in the majority of cases there are still people in hospital and in critical care with the virus, particularly children under five.

This vulnerable age group has high rates of admission to critical care and, sadly, there have also been some deaths. Because of this, children over six months and under five years have been identified as the next priority group for the vaccine. The decision to vaccinate this group is supported by advice from the joint committee on vaccination and immunisation - the UK’s independent advisory board on vaccines.

On 8 December we confirmed that the vaccination programme would be rolled out to children under five years, and that we will start that programme in the run up to Christmas.

The next steps

Negotiators from the BMA’s GPs committee held discussions with NHS Employers negotiators to seek a national agreement on vaccination of this group of children through GP practices. As you will have seen in the media and from my letter to PCTs on 8 December, that has unfortunately not been possible; therefore ministers have decided to ask PCTs to secure the delivery of vaccine to children in this age group through local enhanced services or other locally commissioned arrangements.

I know that those discussions on a local level were ongoing throughout last week. It is excellent news that two regions, London and the North East, as well as other PCTs across the country, have already successfully negotiated a delivery mechanism, and I expect the conclusion of other agreements imminently. I understand that in some areas GPs have already begun vaccinating children, and I have asked PCTs to move as rapidly as possible so that we can get this programme under way across England, before the Christmas break, and so that the transition from phase one to phase two of the vaccination programme is smooth and unhindered.

Progress to date

I know it has taken a huge effort, but the considerable number of people in the high-risk groups now protected against the virus is a testament to the hard work and dedication of all NHS staff, from GP practices, through to the nurses and managers, as well as SHA and PCT staff.

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

This will be my last update for this year, so until January 2010 I wish you all a relaxing and safe festive period.