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With their National Swine Flu hot line scheduled to go online later this week, the plan was originally that anyone with flu-like symptoms would bypass seeing their local GP, and simply call the helpline.
Help desk operators would assist the caller in going over a list of symptoms, and if deemed necessary, would arrange for antivirals to be dispensed.
Even before the helpline went live, there were concerns that high risk patients, such as pregnant women, babies, and those with serious underlying health problems might not get adequate medical screening from non-medically trained helpline operators.
There are, after all, other illnesses that can mimic the flu, and would be difficult or impossible to differentiate over the phone. Even doctors can miss them on occasion.
Today a modification to the National Swine Flu hot line has been announced, and those in high risk groups will still be able to be seen by their doctors.
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H1N1 strain of the swine flu virus Photograph: C. S. Goldsmith/AP
Pregnant women, babies under one and people with underlying health conditions will continue to be treated by their family doctor rather than the government's new swine flu helpline.
Concerns that medically at-risk groups, such as mothers-to-be and cancer patients, need to be assessed by a health professional rather than a call centre worker have prompted ministers to agree that the new national pandemic flu service will not seek to cover vulnerable patients.
A Department of Health (DH) spokeswoman said: "If you have a child under one you should continue to call your GP. If you are in an at-risk group, antivirals are available through the national pandemic flu service, but you will be advised to contact your GP, especially if you are having treatment for a serious condition like cancer. If you are feeling unwell and have an underlying health condition like asthma or are pregnant, take antivirals as soon as possible and keep in touch with your GP."
Senior doctors had privately voiced concerns to the DH that call handlers were not the best people to deal with patients who are potentially at greater risk if they develop the H1N1 virus than healthy adults who have no medical problems.
The 1,500 staff of a new network of about 20 call centres have also been given special training in how to pick up potential cases of meningitis in children, amid fears it could be misdiagnosed as swine flu because the symptoms are similar. The questionnaire staff will go through with callers "includes questions so that potential signs of meningitis are picked up and referred for immediate medical advice", a DH spokeswoman said.
The ability of health care delivery services to provide fast access to antivirals, or other medical services, during a pandemic will be one of the greatest challenges in the UK, and around the world. A great many things will be tried in different countries.
Adjustments are along the way are not only to be expected, they are generally desirable.
Here in the United States, we aren’t hearing much specifically about how the medical community will handle seeing patients this fall, or dispensing antivirals if needed.
Presumably, guidelines will be released soon.
Unlike the UK, where most doctors, clinics, and hospitals are part of the NHS (National Health Service), our hospitals, clinics, and doctor’s offices are nearly all independent operations.
There isn’t a central controlling medical authority.
Whether that turns out to be a curse or a blessing in a pandemic is something, I suppose, we are going to find out.
