New guidance has been published for PCTs on how to deliver primary care services whilst potentially short staffed and how to cope with increased patient demand during the pandemic and the anticipated seasonal flu. 

The current swine flu pandemic is likely to present Primary Care Trusts (PCTs) and primary care services with increasingly significant capacity challenges: not only in terms of demand pressures from patients who present with influenza-like illness or secondary complications arising from swine flu, but also potentially in terms of supply pressures due to illness amongst primary care staff themselves.

This first practical guide to support PCTs in relation to primary care during a pandemic situation covers primary medical care: those services provided by GP practices, GP led health centres and Out of Hours Providers (OOH). Further practical guides will be produced for other independent contractors and to support any vaccination programmes that relate to this pandemic. A guide for pharmacy services and access to medicines is already in development.

PCTs will wish to consider how and when to collaborate with other local PCTs, particularly in urban areas, to ensure a consistent message to the public about where to access services. In line with national advice, PCTs will wish to work with practices and OOH providers to ensure appropriate high levels of take-up of both the seasonal and swine flu vaccinations by front line healthcare staff.

In order for PCTs to concentrate on delivering services whilst potentially short staffed, and to cope with increased patient demand during the pandemic and the anticipated seasonal flu, this guidance sets out:

  • measures that PCTs are strongly advised to consider to support local primary care contractors over both the in-hours and the out-of-hours periods
  • how PCTs should consider their responses to primary care capacity challenges in relation to their overall plan for managing a pandemic to focus activity within the system
  • that there needs to be a key role for OOH providers as they have the infrastructure to make best use of scarce resources should the situation deteriorate
  • that PCTs recognise the contribution made by OOH providers and provide appropriate help and support to sustain their role within the system
  • that PCTs will not be making extra payments to practices, unless the practice clinical/administration staff are working demonstrably longer hours or the contractor is engaging significant levels of additional staff at the PCT’s request (for example engaging additional staff so that they can cover the closure of a neighbouring practice)

The guide is structured around the following topics:

PCT level arrangements

  • Escalation Strategy
  • Dispensing practices
  • Local contracts
  • Out of Hours providers

Individual performer issues

  • Employment of locums
  • Retired GPs
  • Doctors in training
  • Indemnity cover
  • Access to clinical records

National arrangements

  • Emergency arrangements for GP practice income protection


Other primary care contractors