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Nurses quietly confident as NHS battles swine flu pandemic

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Nurses and staff are confident the NHS is coping successfully with swine flu, an exclusive survey by Nursing Times and the Health Service Journal reveals.

But respondents complained form-filling for national and regional planners was a distraction from frontline work.

There is also concern that the seriousness of swine flu for both individuals and the NHS is being exaggerated.

Forty-six per cent of the 1,475 staff who completed the survey thought their organisation was dealing successfully with the extra flow of patients - only 14 per cent thought it was not.

Tellingly, practice nurses - arguably closest to the swine flu front line - were the most confident in their organisation’s ability to cope - with 64% answering positively.

Front-line nurses who deal directly with the swine flu influx are coping - 64% of practice nurses feel their organisation is successfully dealing with the extra flow of patients (8% disagree).

Confidence in organisations’ performance was significantly higher among managers than nurses. All staff had more confidence in their own organisations’ preparedness than in the NHS as a whole.

But on organisations’ readiness for surges in demand later in the outbreak, the average rating was 5.5, where 1 was not at all confident and 10 was extremely confident.

More than half (54 per cent) said they had received useful guidance from the government.

West Midlands public health director Rashmi Shukla said although her region was one of the first hotspots, services were coping well. Very little work had been cancelled and the region was “not anywhere near” setting aside waiting time targets.

She told HSJ: “We have been planning for pandemic flu for several years.”

North East London has also seen hugely increased demand.

Homerton University Hospital foundation trust medical director John Coakley said: “We are coping because we have planned for a much greater incidence and virulence than the current pandemic.” Swine flu should be no more of a problem for the NHS than winter flu, he said.

Dr Coakley added staff needed to focus without being distracted by requests for monitoring information.

Acute trusts are expected to update strategic health authorities each morning on how they are coping and on numbers of swine flu patients as well as reviewing pandemic flu plans.

Heart of England foundation trust accident and emergency consultant Anthony Bleetman said his trust had coped well with up to 100 additional patients daily. It has created a separate stream in its A&E department, rewritten rotas and cancelled a small amount of elective work.

But Dr Bleetman said staff had faced conflicting demands for information, which had included a three-page questionnaire for each swine flu patient.

He said: “It was not something we could possibly do. We need the people giving advice to understand the reality in which we are working. Some of the directives coming down can’t necessarily be implemented.”

Only 19 per cent of respondents said their organisation had begun detailed preparation for an immunisation programme. Confidence there would be adequate vaccine supplies was 4.8 on a scale of 1 to 10.

Dr Shukla said NHS West Midlands and primary care trusts could not create detailed plans until the government identified priority groups over the coming weeks.

Health secretary Andy Burnham told HSJ he wanted to “put on record” that he shared the service’s optimism about preparedness levels: “I would say people should have confidence, individually and collectively.

“I will work hard - it is obviously a fast moving situation - to make sure people have the right support from the centre.”

NHS chief executive David Nicholson said: “I want to thank NHS staff for their continued hard work and support in responding to the early stages of the pandemic. Despite being well prepared, there is no room for complacency.”

NHS Confederation deputy policy director Jo Webber said managers may be reluctant to downplay swine flu risk in case things got worse.

HSJ will continue to track NHS staff confidence as the pandemic progresses.

Mixed picture on workforce plans

Just under half of people working in the NHS believe their organisation has a robust strategy to minimise the impact on services of a swine flu outbreak among staff.

Forty-four per cent agreed that their workplace had a robust strategy - including those who felt strongly that this was the case - while a third disagreed.

Doctors had least faith in their organisations’ strategies, with 54 per cent disagreeing.

But this was true of only 15 per cent of chief executives and board directors and 23 per cent of other managers.

Fifteen per cent said they would avoid going to work if there was a swine flu outbreak among staff.

Among managers, the figure was 13 per cent but only one of 11 chief executives responding said they would stay away from the office.

However, one in five staff nurses and 15 per cent of community nurses said they would stay away.

Just over half - 52 per cent - of respondents said their organisation had given them advice about going to work if they had been in close contact with someone who had swine flu, while 44 per cent said they had received no advice.

Trusts have warned staff they may need to be redeployed to areas worst affected by the virus,

but 61 per cent of workers said they would be unwilling to move temporarily to a different part of the country.

Barrie Brown, lead for nursing at the union Unite, warned that moving staff out to different areas of the country would have “adverse effects” on staff wellbeing, but he said: “The feedback we’ve had is that staff feel their voices are going to be heard in decisions.”

A Royal College of Nursing spokesman urged trusts to communicate clearly with health staff “to ensure that

everyone knows the correct procedures to follow to minimise difficulties caused by the outbreak”.

Health secretary Andy Burnham told HSJ that responding to the extra pressure of swine flu was about “people on the ground pulling together”.

He said: “I will be out and about listening to people, talking to people and if there are things we can do to make their lives easier we will respond to that.”

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