New cases of swine flu went up by 42% in England last week according to new figures from the Royal College of General Practitioners. Children are the most affected with  160 new cases of influenza like illness (ILI) per 100,000 population in children aged 5 to 14. The rate of increase in flu in the south of England has dropped to only 4% - bad news for headline writers who must wait a little longer before “Swine Flu Epidemic Declared in London” can be splashed on the front pages.

But don’t just take the RCGPs word for it. QSurveillance looks at GP databases (over 3000 of them) and counts how many times each diagnostic code is used in consultation notes. Their rate of ILI is currently 86.8 per 100,000 people, similar to the RCGP rate. Interestingly the rate of ILI with antivirals prescribed is less than a third of that at 25.8 per 100,000. That’s 5832 antiviral prescriptions. The good news is that the incidence of lower respiratory tract infection is lower than this time last year, and that of pneumonia is about the same.

NHS Direct feels the strain

NHS Direct, the health hotline designed to take some of the strain away from GPs, received over 9000 calls about swine flu on Tuesday – a swine flu record. BBC News sound quite angry about this.

One of the problems is that hundreds of fundamentally well people are still calling the service with their questions about swine flu, despite there being another telephone number for this purpose.

Dr Peter Holden, the British Medical Association’s lead on swine flu, is less than complementary about the service that NHS Direct is providing.

“As a working GP dealing with possible cases of swine flu NHS Direct has made no difference to my work load and has even made it harder, as I am getting a lot of referrals late in the day.”

Dr Holden has some simple advice for people too.

“Basically go out and buy a thermometer. If you have a temperature and two of the other symptoms you have flu, and should get treatment.”

Meanwhile out of hours GP services are feeling the strain too. I’ve heard of on-call GPs with lists of patients to call back that are so long that often the patient is feeling better by the time they get round to calling them back.

Tom Nolan is the clinical community editor of doc2doc, the BMJ’s professional networking community.