Showing posts with label Flu Line. Show all posts
Showing posts with label Flu Line. Show all posts

Friday, 9 October 2009

Swine Flu: the Pig kicks back

(click image to enlarge)



We thought our last post might just be a one off about Porcine Panic, sorry Swine Flu, for the time being but those busy comrades at Party HQ have been making mischief again using that well known NHS management system of take a (relatively) simple system that works, redesign, it and make it more complicated.

So for most GPs in the United Kingdom to issue a prescription you can print the prescription, or handwrite it for example on a totally unnecessary home visit, on a form usually known as a FP10 and the patient takes it to the chemist (if they don’t throw it in the nearest bin outside the surgery first) and get their drugs.

For the magic Tamiflu the Party and its local Politburos’ made this simple process a little more complicated in that you could do the prescription as above but you had to write the magic Tamiflu spell on the FP10 to unleash the magical power of Saint Tamiflu the miracle worker against the evil swine.

This system did not work due to the infectious nature of the agent called Media who advised the populace to panic. The NHS was then over whelmed by the daily surge of wellness it sees in surgeries being told to stay at home by the chief Medical Officer et al and ring their GP to “contain” the Pandemic (almost an oxymoron) so the National Flu Pandemic Panic Line was launched and a voucher system introduced which worked so well (see here).

Remember, dear reader, all of these things had been planned for years before and so all the Public and Healthcare workers on the ground saw was a “seamless roll out” of these plans in the best prepared country in the world for the Swine Flu.

A small item in one of the GP rags a few paragraphs long said that new vouchers for the magic Tamiflu were being launched and we had seen them being unloaded that day.

We liked the line saying that the vouchers must be destroyed in the presence of a witness clearly to ensure that their magical powers are well and truly ended for fear that they might fall into the hands of those working for the forces of Darkness.

Today we saw them in all of their glory and most of us lost the will to live. In the article it says 3 but in our pack there were 4.

If you click the image at the head of this post you might see why. Gone is the simple FP10 prescription pad and the magic spell to be replaced by not one pad for all ages but a total of 4 pads for children and as well as the FP10 for adults. And the vouchers from the flu line.

May be because we live up North (and are thick) we cannot see why we need a voucher for:

children under 6 months of age
children 6 months and over and up to 1 year of age
children under the age of 1
and
patients (not children) aged 1 and over?

Surely there will have been no cockups in this well prepared country after all the years of planning?

All of these will have been produced at taxpayers expense and sent to each surgery in the country.

So in the best prepared country in the world for flu has someone only now realised that there are different doses for anti flu drugs in different ages after almost 6 months of disease? Obviously no paediatric or anaesthetic input in these plans given the weight charts on the forms.

At a recent meeting we went to when a collection of 10 GPs were asked how many Tamiflu prescriptions had they issued it came to 3 in a population of some 15,000 but each GP when asked how many patients they had seen who had had Tamiflu most said about 10 each via the Swine Flu line. All these patients came back because they were no better.

Praise be to the Party whose management motto must be if it is simple and works make it more complicated and break it. The Pig is well and truly kicking the best prepared country in the world in the nuts and making some people look like complete idiots.

It hasn’t even turned nasty yet. What if it does?

Wednesday, 12 August 2009

Tales from the Flu Line


Today we had some instances of how well the use of medically untrained call centre operatives are having a huge impact in the phoney war that is the current swine flu “crisis”. We saw our first patient who had successfully completed his free flu Tamiflu after ringing the Swine flu line service. He had seen one of us a few days before who had made the correct diagnosis (viral upper respiratory tract infection) and they had been given the correct advice (paracetamol, fluids and it will get better on its own).

However, because all patients here in Northernshire are more qualified than their doctors, as his minor symptoms did not get better after 2 curative doses of Lemsip Max strength flu cure and it was clearly a case of severe Swine Man flu he rang the Panic line and despite a constant temperature of 37 degrees he got a box of the magic Tamiflu and an instant week off work to watch the cricket, sorry, recouperate.

So in a controlled study of one, Tamiflu does nothing as he was still coughing although slowly getting better as one would expect from a simple but very common viral upper respiratory tract infection that most GPs will be seeing at this time of year.

The widespread use of Tamiflu in such people will almost certainly accelerate the development of resistance in virus(es) due to its indiscriminate use.

The second case yesterday shows how Tamiflu seems to be given out without any consideration of other medical matters. We tell our students that before they prescribe they must always ask about allergies and also is the patient on any other medicines to prevent drug errors. A patient had rung the swine flu line and was debating whether to take Tamiflu as he was on anti epileptic drugs so rang to ask.

There is very little information on drug interactions with Tamiflu (certainly none we could find in the prescribers’ bible the British National Formulary) and the Summary of Product Characteristics thinks that interactions are unlikely. We often joke that if a drug has no side effects it doesn’t do anything so does that mean a low risk of interactions is similar?

We do not know if swine flu line operatives ask about other disease and medications or allergies but it is a bit worrying that patients are thinking to ask these questions of their doctors before taking a drug that has not be prescribed by a doctor.

Praise be to the Party for its contribution to medical science by conducting one of the largest clinical trials of a drug not being prescribed by a doctor to unseen patients over the phone. Bet they got that one past an ethics committee in a couple of days?