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Ian Dalton's swine flu update - preparing for a possible second wave

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In his weekly update for Nursing Times, national director for NHS flu resilience Ian Dalton discusses what is being done to ensure the NHS is prepared for a possible second wave of swine flu

What should NHS staff be focusing their efforts on?

Over the last couple of weeks we have begun to see an increase in the number of cases of swine flu with increasingly numerous outbreaks in schools. While it is too early to say whether this trend definitely indicates the start of the expected second wave of the pandemic, we should all plan on the basis that it might and that we therefore have a few weeks to ensure our preparedness is as its highest possible level

Over the last month or so I have been providing updates on the resilience planning that has been under way within the service, and the excellent progress that has been made is a testament to the hard work and commitment of staff and managers across the NHS.

It is crucial, however, that we continue to build on this hard work. Given that we could experience a surge in demand at any time, we need to have all our plans in place by the middle of October.

The next steps

To help ensure our plans, including those for critical care and vaccinations, are as robust as possible, the NHS has been carrying out two key exercises. During September, all 10 strategic health authorities have been carrying out assurance exercises so that they are in a position to declare their levels of preparedness at their September board meetings. Given the planning work that has been carried out over the past few weeks, months and years, I expect that all 10 SHAs will be in a position to declare themselves prepared for a second wave and beyond. 

All SHAs, in conjunction with the Health Protection Agency and the Department of Health, are also in the process of staging regional stress testing exercises to  ensure that their resilience plans are as robust as possible.  A number of SHAs have already held their events, and they have proved a useful opportunity to test their plans against a number of potential scenarios. I have had the opportunity to attend a number of these exercises and have valued the chance to see the regional plans being put into practice and to discuss national and regional plans with a number of colleagues.

Last week I reported on the conclusion of the negotiations with the British Medical Association’s GPs committee to agree how the swine flu vaccine will be delivered, and this week I am pleased to be able to tell you that on 25 September the European regulator, the European Medicines Agency, recommended that the GSK vaccine should be granted a licence by the European Commission.

This is a positive step towards getting full licences for vaccine to protect the public. The European Commission must now consider the recommendations and we hope for their decision as quickly as possible.

We have some potentially difficult months ahead of us, but continuing to work and plan together as a system will ensure we are able to maintain the NHS’s excellent response to the pandemic so far. 

Progress to date

The HPA has reported that the rates of flu-like illness and related activity have shown further increases in England – from 5,000 cases last week to 9,000 this week.  Further details on the weekly figures can be found on the HPA website where you can find more details about GP consultations, antiviral collection data and hospitalisations.

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