With the possibility of a second, more serious wave of swine flu ahead, Ian Buchanan focuses on the work being done by hospices to prepare for an outbreak.
A pandemic flu outbreak could have a huge impact on healthcare providers, resulting in depleted workforces and mass disruptions to services. Even a severe infection with a low mortality will have a major impact on every part of society.
Palliative care teams, including hospices, are an integral part of the health system for highly vulnerable people, caring for a quarter of a million people each year. In the event of a more serious outbreak, they may have to cope with an increased demand for admissions, while coping with fewer staff and reduced access to key services and supplies. Hospices run more than 3,000 inpatient beds and any closures would place serious strain on NHS services.
Therefore, it is essential that hospices plan for an outbreak, to ensure continuity of service and a rapid and effective response. In light of this, hospices, supported by UK hospice charity Help the Hospices, have been proactive in developing comprehensive guidance on flu planning which supplements the resources offered by the UK governments.
‘Flu pandemic planning: advice for hospices’ was first published in 2007 and was updated in May this year following the threat of swine flu. It includes an organisational planning checklist, an action template and information on infection control, vaccines and antivirals. The guidance is available on the Help the Hospices website, which also contains an area dedicated to communicating information about the flu pandemic across the hospice community. Here hospices can share good practice and access resources and regular updates.
It has been encouraging to see the interaction between hospices and the sharing of knowledge. However, it has been a struggle to get hospices included in national and local flu preparedness plans.
Help the Hospices has been working with and on behalf of hospices to stimulate engagement with key partners and to ensure hospices are recognised by the government as key organisations in responding to a pandemic. It is lobbying the Department of Health to allow frontline staff in voluntary hospices to access the H1N1 vaccine, and has encouraged hospices to challenge their PCTs and local flu preparedness teams to include them in their plans. It also ran a workshop on flu pandemic planning, which looked at planning with partners in the local health community.
There is a desire among hospices to continue to improve their capacity to respond to pandemic flu and to learn from other hospices and partners as they take the development and implementation of their plans to the next stage. Despite the positive steps that have been made, pandemic flu planning will need to continue to progress in hospices to ensure that responses are both robust and flexible.
In addition to this, hospices will need to consider how their collaborative approach to responding to pandemic flu might offer useful learning for reacting to other public health challenges which may confront them in the future.
To find out more about hospice care visit www.helpthehospices.org.uk
Ian Buchanan is manager, monument integrating governance programme, Help the Hospices. Claud Regnard is consultant in palliative care medicine, St Oswald’s Hospice.