30 Sep 2009
1. This statement responds to DH surge guidance and sets out actions taken by NHS Direct to prepare for the challenges posed by the anticipated next wave of flu pandemic.
2. NHS Direct has two distinct areas of operation which relate to flu. Firstly, NHS Direct operates telephone and internet services which provide information, advice, guidance and support for patients and the public 24 hours a day, 365 days a year (its core services). Secondly, NHS Direct is responsible for the day-to-day operation of the National pandemic Flu Service (NPFS), which enables patients with flu-like symptoms to assess via the telephone or the internet, whether they would benefit from antiviral medication and to be authorised to obtain antivirals from local collection points. The NHS Direct core services and the NPFS use separate call centres and separate frontline staff.
3. The Board of NHS Direct has made sure that there are senior directors responsible for ensuring that the organisation is well prepared for a potential second wave of flu that might last up to five months. The Chief Operating Officer of NHS Direct is the Board Director responsible to the Chief Executive for flu preparedness for the core services. In addition, the Trust has in place a full-time senior manager responsible to the COO for the day to day flu preparedness activity for the core services. The Commercial Director is the Board Director responsible to the Chief Executive for Flu preparedness in the NPFS.
4. The NHS Direct Board is satisfied that all reasonable actions have been or are currently being taken to prepare its core services for the second wave of flu. Additional health advisors and nurses are being recruited and trained to bolster the Trust’s ability to meet the forecast rise in demand. We have put in place other measures to increase our capacity and the resilience of our infrastructure. However, in the peak of the pandemic we anticipate that we will not be able to continue to deliver all services for all patients to our usual standards. We have therefore planned to prioritise groups of patients and services, so that those in most urgent need can continue to receive a service. Patients with non-urgent needs will see some degradation in service during the peak.
5. NHS Direct has put provisions in place to ensure effective prioritisation of patients and services. Those provisions have been made available to and discussed with key stakeholders. Pandemic flu peaks will be managed to ensure that all priority cases are dealt with within acceptable service standards.
6. The NPFS has been designed and built to have sufficient technical capacity to meet the peak demand of the pandemic. It has been subject to rigorous technical and user acceptance testing to ensure that it is fit for use. The operational call centre capacity to help patients conduct NPFS assessments is currently commissioned from private sector providers, which can be flexed to meet the anticipated surge in demand. Patients are also encouraged to use the internet. All suppliers to the NPFS are contractually obliged to have a pandemic preparedness plan. NPFS is currently being managed as a stand-alone service hosted within NHS Direct and has a mixture of contractor and NHS Direct staff seconded to the service. All staff have an identified back up person should they be unable to work through illness.
7. NHS Direct has taken the following action:
a. Taken account of national guidance and imperatives.
b. Established clear governance for the Trust’s pandemic response, including appointing a full time Flu Preparedness Programme Director.
c. Revised and re-issued on-call provision.
d. Launched the National Pandemic Flu Service.
e. Adapted its online and telephony services to optimise support to patients and the NHS and to better absorb the increased volumes during the flu pandemic.
f. Set in train measures to prioritise services and patients, and to increase capacity.
g. Reviewed its arrangements for processes, premises, providers and people, including:
h. Activated (in June 2009) a Pandemic Flu Continuity Plan agreed with commissioners.
i. Refined that plan following the stress-testing afforded by the earlier wave of influenza and to allow for graded escalation and de-escalation.
j. Activated in June 2009 its command and control structures.
k. Established regular communications with staff and stakeholders.
l. Established a communications channel with the Health Protection Agency.
m. Established that NHS Direct staff are not eligible for the flu vaccination programme.
n. Discussed contingencies and mitigation with national and local commissioners.
o. Agreed contingencies for The Appointments Line with the service commissioner.
p. Refined its approach based on organisation-wide appraisal of stress-tested continuity
