Saturday, 20 February 2010

A new change in NHS Porcine strategy?

On our regular trawl of medical rags one of the team noticed a little piece entitled “GPs to check for swine flu”. It would appear that the National Swine Flu Pandemic line is being shut down and Sir Liam Donaldson will be writing to us.

Now most GPs in the UK will, we are sure, be up in arms knowing that this vital resource is to disappear as they will have seen loads of correctly diagnosed cases of swine flu appear in their surgeries saying they are no better after Tamiflu and are coughing up loads of green phlegm, finding it painful to pass urine and have sinus headaches.

They will, however, take great comfort in knowing that it could be reinstated in a week should the need for this vital service come again.

The setting up of a call centre is a great Za Nu Labour tradition and the success of NHS (re)Direct shows what a cost effective waste of trained nurses they can be. Those of us at ND Central who are of a slightly cynical disposition wonder how long it will be before a “Turn In a Taliban” hotline will be set up to help our boys and girls in Afghanistan? Surely it is better to use a mobile to turn in an insurgent rather than detonate an IED?

Call centres, so much better than real soldiers or nurses on the ground.

We digress slightly. It would appear that the director of porcine matters has sent a letter to practices saying that they should now deal with swine flu enquiries. When we left it had not arrived on our desks so what follows is based on the article alone. Could it be this one?

The article in the GP magazine, sorry we can’t link to it, says that GPs should use the algorithm used (so successfully?) by the Swine flu line to determine who gets Tamiflu.

Now we at ND Central thought, being professional and medically trained, how can we use a highly sophisticated tool without some form of training? Surely each doctor, nurse, receptionist and (window) cleaner who is there to diagnose swine flu, which the National Pandemic Flu Panic line has done so successfully and efficiently, will need at least the 3 hours training given to each call centre operative before we can even stand a chance of being able to play scrabble and diagnose swine flu.

It would be clearly irresponsible for any healthcare professional, even one who remembers algorithms from the 1970s for programming computers with Fortran and Cobol languages, to even dare to use an advanced algorithm to determine who should, or should not, be issued with a Tamiflu voucher (if we could find one) without the 3 hours training.

One of the team has managed to save their patients from the widespread slaughter by the evil swine flu but in doing so has only issued 2 prescriptions for Tamiflu. One we have blogged about before and the other was a case of identical twins one swine flu line positive and was to avoid a potential complaint for not issuing it and was totally unnecessary. Only one of these prescriptions was actually dispensed.

Still it is good to know that the director of all things porcine has deemed fit to write to his humble serfs called GPs and tell them that they are now the National Panic Flu line.

Of course we could always as doctors continue to do our jobs and try and avoid missing “swine flu line” appendicitis and “swine flu line” meningitis all diagnosed using an algorithm and scrabble and successfully dispatched with Tamiflu.

Praise be to the Party and its director of all matters porcine. We are sure many will pray to him when desperate and their faith and trust will be appropriately rewarded. We grunts on the ground will stick with our training and not bother with the algorithm or Tamiflu.

Interesting how many letters we have had from the local Darzi centres that contain the nurse generated diagnosis of “Influenza” and the patients are treated with Tamiflu and Erythromycin. Clearly our training is so out of date with “modern” medicine here up North.

Or is it?

1 comment:

Anonymous said...

Was it not correct to prescribe Erythromycin along with the tamiflu (if we imagine it worked). I was told after I answered a question on prescription of antibiotics for a viral infection for a UCL medical interview that in vulnerable patients it can be valid to prescribe antibiotics for oppurtunistic bacterial infections which might crop up? Is that an uncommon or foolish practise?