1. Pandemic Flu: A perspective from NHS Direct and the National Pandemic Flu Service
Ronnette Lucraft
Commercial Director, NHS Direct, and
Operations Director, NPFS
26 November 2009

2. Agenda NHS Direct’s role in Pandemic Flu preparedness and response
Objectives of the National Pandemic Flu Service
The interface with Emergency, Urgent and Primary Care
Usage and patient feedback
Differences between the Interim and Strategic systems
What next?

3. NHS Direct’s role in Pandemic Flu preparedness and response
Multi-channel info and advice
National resilience to support local hotspots
Encourage self care when appropriate
Lend experience and know-how for the establishment and operation of NPFS

4. Objectives of the National Pandemic Flu Service
assist the right people to get the right treatment, at the right time
enable those who have flu to stay at home
help manage the impact of flu on the wider NHS
protect the stockpile of antivirals and support a fair and equitable release

5. Hello… welcome to National Pandemic Flu Service2
Hello… welcome to National Pandemic Flu Service
2. Assess 1
1. Contact
National Pandemic
Flu Service
Click next for assessment
Antiviral
Collection Point
National Pandemic
Flu Service
FluLine
3a. Authorise
Authorisation
Number:
URN:
4. Collect
NJFL 9857
3b. Hand-off
National Pandemic
Flu Service
Click next for assessment
3c. Advice
Drink lots of water…

6. Go Live Summary At Go live the NPFS had:
3500 agents trained and ready to take calls in 19 centres, operating from 8am to midnight
A web service available on
A recorded information line
A network of Anti-viral collection points
Clinical liaison in partnership with the RCGP

7. The interface with Emergency Care
Initial questions to identify life threatening conditions which require an emergency response.
Changing words have changed referral rates without compromising patient safety
Considerable effort with the call centre agents to ensure that they are not “leading” the patients
Before we begin the assessment for flu, we need to check if the patient needs an emergency ambulance
Before %
Before we assess the patient for swine flu, we need to ask two questions to check whether the patient needs hospital care now. If the patient answers 'yes' to one of these questions you will be advised to call 999 immediately and we will not go on to do the flu assessment, as this could delay urgent treatment.
After
5 - 6%

8. The interface with GPs and OOH
Questions within the algorithm determine whether the patient is referred to primary care for additional assessment and treatment
This applies to:
all patients under one year old
Pregnant women
Renal patients
high risk groups
Those with additional symptoms – complications
Work is on-going with the DH and RCGP to ensure that
referrals are appropriate
the messaging at GP practices is consistent
OOH providers are briefed

9. NPFS Usage Cumulatively from Thursday 23 July to Tuesday 17 November
2.25m assessments have been completed
1.53m URNs have been issued
950k AVs collected.
Circa 40% of assessments have been completed on-line

10. NPFS Usage – by time of day and day of week
The peak hour of callers to the NPFS is between 9and 10am on Monday mornings
The service is used considerably more during the in-hours rather than OOH period
Calls delivered to NPFS call centres, w/c 2/11/09

11. NHS Direct impact
The launch of the NPFS had a real impact on the number of callers to NHS Direct
Telephone calls answered by NHS Direct
Callers recently seem to have a higher level of acuity, and there are more symptomatic patients rather than information seekers
Weekends and OOHs continue to be the busiest times

12. NHS Direct impact (2)
The NHS Direct web services helped it to deal with a high proportion of enquiries
An average of 7k uses of the Colds and Flu symptom checker per day
Peak of usage of 175k in one day
Over 10m page views on NHS.uk and NHSdirect.nhs.uk since 27th of April

13. Patient feedback on the NPFS
As of the end of October, there had been 31 formal complaints
There has also been a number of pieces of informal feedback
Topic
Number
ACP issues
243
Website issues
238
Callcentre Issues
108
Other parts of NHS 60
We have also received a number of compliments

14. Key functional differences between the Interim and Strategic systems
Use of Health Number and associated look up systems
URNs can be re-issued
6 Languages for web- English, Welsh, Portuguese, Polish, Turkish and Russian
IVR
Targeted and Treat-all algos
NPFS Professional
Web based MI
There are no current firm plans to mobilise the strategic solution during this pandemic

15. What next?
The second (and third?) wave and interplay with seasonal flu
Very difficult to forecast!
Planning for the switch off and dormancy of the NPFS is underway