How does a doctor obtain informed consent for H1N1 immunisation consistent with General Medical Council guidance? The Department of Health’s guidance does not provide sufficient information for this.  This is our attempt to rectify this omission, providing information required for informed consent consistent with good professional practice. We outline the main principles of General Medical Council on the responsibilities of doctors in seeking informed consent into practical guidance.  more…

Plagues create business opportunities and the worried well in any era present a commercial opportunity. In the Middle Ages, the Black Death and the Great Plague saw brisk sales in fumigators, herbal remedies, and the plague suit - predecessor of the DuPont TK555T HazMat suit, and equally unsettling for nervous patients. Quacks (from the old Dutch word Quacksalver, for one who boasts or “quacks” about his or her salves) thrived in an era unchallenged by scientific evidence and online Cochrane reports. more…

Increasing numbers of clinical staff at the hospital where I work declined invitations to be vaccinated against pandemic “swine” influenza. I think this is a worrying trend for both public health reasons and for the doctor’s integrity as a medical practitioner. There have also been reports in the popular press of doctors refusing the jab. As more NHS doctors object to what they perceive as an untried and untested vaccination, does the NHS as an employer, or the GMC as a regulatory authority have any recourse against these doctors? The GMC’s good medical practice publication, paragraph 77 clearly states: “You should protect your patients, your colleagues and yourself by being immunised against common serious communicable diseases where vaccines are available” [1]. With the current situation of a new vaccination against an infectious disease which likely has yet to bear its full impact, we need improved definition of the terms “common” and “serious” to support doctors whom decide not to be vaccinated. I also believe the NHS, either locally or nationally, should provide guidance on the matter.

Reference:

1. General Medical Council (2006) Good Medical Practice

Andrew Potter is a GP trainee having previously worked as a registrar in cardiology, gastroenterology, and acute medicine. I currently work in obstetrics and gynaecology at Bedford Hospital.

New guidelines on the management of pandemic H1N1 influenza were published recently by the Department of Health. They include guidelines on when to refer patients to hospital (see below) and an update on the epidemiology of the disease: fewer than 1% of cases are admitted to hospital; 12-15% of patients admitted to hospital go on to need high dependency or critical care; and mortality for hospitalised adults is around 6%. more…

One thing about the current swine flu pandemic is that it has brought with it a universal sense of fear. As with all fears, individuals respond differently, but we know what they are feeling because the sensation of fear, which varies from a mild anxiety to incapacitating panic, is so much part of our constitution that some see it as a normal component of the human condition. more…

The H1N1 vaccination programme is underway in the UK and many other countries across the globe. In Sweden a million people have already been vaccinated. One swine flu vaccine manufacturer, GlaxoSmithKline, expects to produce 440 million doses over the next few months. With newspapers, television and the internet raising doubts about the safety of the vaccine, many doctors will be consulted by anxious patients wanting to know whether the vaccine is safe and effective. more…

The swine flu vaccine is officially here. The UK government announced on Friday that over 400,000 doses of the swine flu vaccine will be delivered to hospitals this week. The first to get the jab (from Wednesday) will be hospital inpatients belonging to at-risk groups and hospital staff. Next week GPs are due to start vaccinating patients according to their priority status, which are as follows (top priority first): people aged six months to 65 years with underlying health problems and the immuno-suppressed; pregnant women; household contacts of people with compromised immune systems; people aged over 65 with health problems. The Daily Mail are characteristically concerned about the vaccine, in particular its use in children. more…

England’s chief medical officer Sir Liam Donaldson can sound gloomy and pessimistic but he sounded very upbeat in this week’s swine flu update, saying: “We may have got a lucky break in how the virus has behaved at the start of our flu season and we may be able to get the vaccine out there before our flu season really gets under way. I’m looking at it very optimistically.” more…

The BBC trailed it as everything you need to know about swine flu. The title probably raised my expectations too high.

A street poll near the start of the programme showed that the public were a bit confused about who was at the most risk of swine flu, so it seemed the programme had some scope to educate viewers; and it did feel a bit like a government broadcast, or a school education film. Three presenters travelled the world to “expose the myths and the dangers of swine flu,” interviewing “swine flu survivors and the relatives of its young victims”. more…

PLOS Currents: Influenza is a journal with a difference. Mixing features of a journal with those of blogs and discussion forums it’s bound to ruffle some feathers. It describes itself as “a moderated collection for rapid and open sharing of useful new scientific data, analyses, and ideas.” Contributions are not peer reviewed other than for intelligibility, relevance and suitability. You can rate and comment on submissions and see how many other people have read them. Is this the future of research or a dangerous drop in standards? more…