1. Workstream 4 Primary Care Surge Capacity & Business Continuity Issues of focus Where we are now Key challenges

2. Issues of Focus Managing the surge –GP Practices –Community Pharmacies –Dentists & Optometrists –Local FPU Offices Facilitation of contractors –Plans –Buddying & Clustering Arrangements

3. Issues of Focus contd Training & Awareness Raising –General & Specific Plan Related Buddy / Cluster Information Flows Medicines Supply Issues PPE - Standard & Specific – Standard Stock Replenishment –Fit Testing for staff from all Practices

4. Issues of Focus contd Out of Hours –Out of Hours –In Hours Database Development –Flucon & Other Requirements Local Office Reorganisation

5. Where we are now Plans - template based for standardisation –GPs - developed, submitted & reviewed Push for those not submitted Critical data set requested Training includes plan implementation & buddy arrangements –Community Pharmacies - ongoing Push for those not submitted Assistance for those who need help Clusters Determined Facilitation of Cluster Implementation

6. Where we are now contd –Dentists - Guidance Sent Out –Optometrists - Finalising Arrangements Out of Hours –Major Piece of Work Undertaken – Issues / Gaps Identified & being Addressed –Capacity to Cope In as well as Out of Hours –Business Case being Finalised Staffing & Other Resources

7. Where we are now contd Training etc –Taken Place in All Areas –Building on Earlier Awareness Raising –Practical Issues Raised –FAQs –Use of Intranet for Updates etc PPE –Standard Stock in Practices –FFP3 Fit Testing Mop Up Underway –Stock Replenishment Model Developed

8. Where we are now contd Databases (& user guidance) Developed / In Development for Flucon, Stock Monitoring / Ordering, other information requirements (Apollo) Capacity Review of Local Offices – Determination of Key Swine Flu & Non Swine Flu Essential Tasks –Reassignment of Duties

9. Key Challenges Staffing –Organisational Change & Loss of Key Staff –Co-Ordination of Remaining Staff across Local Offices for Essential Swine Flu & Non Swine Flu Tasks Independent Contractors –National & Local Contractual Arrangements Outside our Control –eg Standing Down of QOF –Command & Control - Is is Possible?

10. Key Challenges contd Out of Hours –Ensuring Robustness –Triggers & Mechanisms to go from Buddying to OOH when Buddies Break Down Interface Issues –Communication –Admission & Discharge Information Timeliness of Discharge Summaries –Quick Contact for Specialist Clinical Advice

11. Key Challenges contd Maintaining the Pharmacy Network & Medicines Supply Chain –Communications Issues Running Pandemic Immunistation Programme at Time of Surge Ensuring Robust Leadership & Process with Clear Understanding of Decision Making Ability