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Ho Ho. As any fule kno if you can deal appropriately over the phone there is no obligation to see someone face-to-face and my guess is that we will be able to do this. There is no obligation to see a patient face to face to issue a prescription for tamiflu or for amoxicillin for the secondary bronchitis. There is no obligation to deliver FP10s. There is no obligation to visit to confirm death, so as far as I can see it can all be handled by the NHS commissioning NHS Direct and co-ops to do special flu management services and the ambulance service to provide paramedics on bikes to do recognition of deaths. GP practices can get on with their QOF activities. What will be needed will be home nursing but that will have to be done by relatives since the DN service doesn't actually nurse anyone any more. Maybe the community matrons can be organised to train relatives in how to provide basic nursing care. I have some good books on home nursing from the early 20th century which might be helpful! The biggest problem will be facilities for dealing with dead bodies. Remember a few winters ago -refrigerated lorries etc. In fact I'm sure Sir Liam will be looking forward to us doing it on the phone since there will be no way otherwise to deal with the masses of cases and exposed docs will get ill and be taken out of the workforce. The radio has just said that Sir L says we won't get it this year (so that's ok then, 10 weeks to go) and that GPs and vets are being briefed. I looked up various websites yesterday so I could brief the co-op and there is nothing useful more recent than 2003. Off to the Badger Sett now, amazingly nobody ringing us yet re whether they have got bird flu. Everyone has flu round here of course (what we doctors call coryza) Tararabit Fay ----- Original Message ----- From: "Paul Caldwell" <[log in to unmask]> To: <[log in to unmask]> Sent: Sunday, October 16, 2005 5:40 PM Subject: Re: avian flu, now duty of care to me? can i sue? > yeah the vaccine doesn't work and tamiflu is a v best modest. > heres a thought. according to the cmo yesterday, all nhs staff, and he > named GPs first, will be required to see these pts at home (duty of care > etc) coughing trillions of lethal virus over us. all we'll be offered in > protection is a face mask (not even a respirator) and tamiflu. if i got > the virus and died, would my widowed family be able to sue the NHS for > breaching their duty of care to me to provide proper protection for its > staff against a known serious threat. remember in the 1970s birmingham med > school got seriously fined when smallpox virus leaked out and killed a > secretary- and that was an accident.Here the NHS would be requiring its > staff to expose themselves lethally. > any chance the BMA lawyers have an answer to this one? eh fay?! > > >>From: Chris Salter <[log in to unmask]> >>Reply-To: GP-UK <[log in to unmask]> >>To: [log in to unmask] >>Subject: Re: avian flu >>Date: Sun, 16 Oct 2005 14:50:21 +0100 >> >>Hello Mary and GP-UK, >> >>Saturday, October 15, 2005, 6:46:50 PM, Mary wrote: >> >> > In message <[log in to unmask]>, Chris Salter >> > <[log in to unmask]> writes >> >> >>Saturday, October 15, 2005, 9:17:43 AM, Mary wrote: >> >> >>> Should we be asking for space suits as well? How effective are they >> >>> in >> >>> cases of 'flu? If they were useful in SARS, why weren't we told? >> >> >> >>> My instinct would be to stockpile supplies and keep home in >>isolation... >> >> >> >>I have arrived at much the same conclusion although it raises a number >> >>of issues. One of which is should patients on long-term medication be >> >>allowed/encouraged where practical to obtain say six months supply >> >>with a repeat two months before their supply runs out? In the event of >> >>a significant outbreak the Government advice may well be to stay >> >>indoors so the last thing you would want to do is travel to the local >> >>pharmacist to pick up your prescription. What does the team think? >> >> > At the millennium - when we didn't know whether the worst case scenario >> > might occur - I did something like that for some of my patients. >> > The shelf life of insulin - which has a very long production/supply >> > chain and is not manufactured in the UK - is 3 months in the >> > refrigerator: prednisolone for asthmatics is cheaper and lasts >> > longer..... >> > I recommended a months supply of food which did not require cooking - >> > and bought a wind-up radio and dynamo torch for myself... >> >>While some may well wish to plan for the worst case scenario (e.g. >>DEFCON 1 Equivalent [Note 1]) I was thinking more in terms of 'DEFCON >>3'. In the Millennium Bug scenario, utilities would have failed >>because the control systems failed. If a bird flu pandemic takes out >>the workforce to the point that utilities fail we are all in deep >>trouble! From a less pessimistic viewpoint, I am focusing on the point >>when some form of outbreak (human infection) may appear *very likely* >>but before the Government advises 'stay at home'. I admit that at the >>moment I am not at all sure how that point would be determined but >>suspect we will get a better idea as the weeks and months pass. >> >> > A bird flu epidemic would be worse: if patients are advised to stay at >> > home, who is going to make deliveries? >> >>It *seems* a reasonable assumption that there are plans for >>distributing these millions of doses of antivirals that don't >>contribute to spreading the infection! However, I must reemphasize >>that I am suggesting that patients obtain a reasonable stock of >>existing long-term medications *before* the risk in doing so becomes >>significant. >> >> > Joking aside, surely the first thing would be to close the schools? >> > Can't think why it wasn't done in the last food poisoning outbreak.. >> >>I would guess that if contingency plans are not *already* in place >>most decisions are taken later than is probably desirable. >> >> > MaryH >> > PS would your pharmacist be *able* to fill the prescription? >> >>See above. >> >>Chris >> >>Note 1. >> >>DEFCON DEFense CONdition >>http://www.fas.org/nuke/guide/usa/c3i/defcon.htm >> >> >>-- >> Chris Salter mailto:[log in to unmask] >> Lincolnshire Post-Polio Network http://www.lincolnshirepostpolio.org.uk/ >> Polio and Post-Polio News >> http://mt.lincolnshirepostpolio.org.uk/pandppnews/ > > > > > -- > No virus found in this incoming message. > Checked by AVG Anti-Virus. > Version: 7.0.344 / Virus Database: 267.12.0/134 - Release Date: 14/10/2005 > -- No virus found in this outgoing message. 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