Tom Nolan: Collection point nonsense

Talk of swine flu seems to have died down considerably since the launch of the national flu pandemic service in England last week. Despite the lack of news generally, it’s no longer on the front page of every newspaper – perhaps due to the telling off that the media got at the weekend (see Monday’s blog). We’ll find out tomorrow what the latest GP consultation rates are and hopefully the number of calls to the flu line and doses of Tamiflu given out. Anecdotal reports suggest that we should expect a decrease in consultation rates: one GP in North London reports a much quieter out-of-hours shift this week: the number of people waiting to be called back at the start of an out of hours shift had dropped from over 200 to around 30, most of which were for non-flu related illness. Steve Field, Chairman of the RCGP, describes a similar improvement in Birmingham in a letter to members.

As you probably know I’m a GP (albeit part-time these days) at Bellevue Medical Centre in central Birmingham which at one point was the flu capital of the UK. The pressure appears to be easing for us in Brum although I know it is increasing in other parts of the country.

Find a full update on the latest figures on Friday’s blog.

“Collection point nonsense”

Where would this blog be without Michelle Drage, joint CEO of Londonwide LMCs? Her latest rant/update tackles sick notes and antiviral collection point “nonsense”.

There is no point in refusing medical certificate requests when the government has clearly lost its senses over what is and isn’t best practice clinically. My 3 “Step advice is to use your usual judgement and if you believe the patient is not ‘swinging the lead’,

STEP ONE – Issue a MED 5, and under B, cross out the printed words, and insert the words:

“In the current pandemic flu situation based on what the patient tells me”

STEP TWO – Under “diagnosis” insert the words:

“Presumed Swine Flu”

STEP THREE – Document in your own records any 3rd party references the patient may have had, or any phone contacts with the practice.

But what about the flu line and antiviral collection points (ACPs)? The jury seems to be out on the flu line until their survey results are known. There’s no doubt about Michele’s feelings on ACPs though.

If you believe that universal prescribing of Tamiflu is a good thing, then you’ll be disappointed that some centres appear to be open Monday to Friday.

If like me you believe it’s a wholly over the top political reaction designed to distance responsibility from politicians, and has no resonance with the pressure on us not to prescribe antibiotics for common colds, then you may feel there is a god.

An Ode to Tamiflu

You’re never more than a few clicks away from the next big YouTube hit, so it was only a matter of time before we had one about swine flu. Harry Houseago, a thirteen year old from Dulwich, South London, wrote his “Ode to Tamiflu” after being given the drug after his school was closed during the containment phase of the outbreak. It describes his battle with side effects of the drug:

I remember they gave us pills
Saying “This is so you won’t get ill”
But now I know
This is worse than any cold
Oh Tamiflu, it’s down to you
That I’m feeling slightly nauseous
And now I’ve got a pain in my head
So I think I’d better stay in bed.

Here’s the full version for your aural pleasure.

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