Mind responds to consultation launch on emergency changes to the Mental Health Act

The Department of Health have today launched a consultation on whether they should make temporary changes to the Mental Health Act to allow for exceptional circumstances as a result of pandemic flu. The consultation will consider whether to reduce the number of professionals involved in sectioning people under the Act, should flu lead to severe staff shortages.

Mind's chief Executive, Paul Farmer, said:

"We recognise that these are exceptional circumstances and that to keep mental health services going during a period of low resource it is essential that emergency measures are in place. However, any proposals that will reduce the number of professionals involved in the sectioning process are concerning. Sectioning effectively deprives people of their liberty, and the reason that a number of professionals are involved is to ensure that the best decision is made for the patient, and no one is detained inappropriately. We have to be clear that these are serious changes, and should only be used as a last resort.

"The Government must ensure that plans are carefully crafted, clearly identifying how and when emergency powers will be triggered and that robust safeguards are in place to protect mental health patients. It is important that the Care Quality Commission plays a role as regulator to ensure that people will not be disadvantaged by any new measures introduced."

Department of Health consults on pandemic flu contingency legislation for mental health

The Department of Health today launched a consultation on whether there is a need to make temporary changes to the Mental Health Act 1983 should exceptional circumstances arise during pandemic flu. The contingency legislation would enable mental health patients to continue to get the treatment they need in the event of severe staff absences

The 1983 Act enables people with mental health problems to be detained in hospital, where necessary and justified, for care and treatment. The Act sets out a range of processes that professionals have to follow when people need to be detained. For example, detaining someone normally requires the agreement of two doctors.

We are consulting on whether we should temporarily change certain aspects of the 1983 Act in the event of severe staff absences during pandemic flu. The changes would ensure that mental health professionals could continue to operate the Act in the best interests of the patient and for the protection of others.

Strong safeguards would remain in place to protect patients rights, for example, the right to an independent mental health advocate. In addition, if the contingencies are implemented, we also propose to ask the Care Quality Commission to convene an oversight group with representation from national mental health service user and professional bodies to advise on progress and the need for ongoing contingency measures.

Louis Appleby, National Director of Mental Health Services said:

“There are already strong contingency plans in place for pandemic flu in mental health services, as there are for the rest of the NHS.

“It is important that we find out whether temporary changes in the Mental Health Act would help professionals and protect patients. We will also consider what in what kind of exceptional circumstances we might need to use them. It would only be in exceptional circumstances and strong safeguards would remain in place.

“We are determined to make sure we have a sensible, proportionate approach that ensures that vulnerable mental health patients continue to get the treatment they need, when they need it, even in the event of staff absences. It is only sensible to be prepared for every eventuality.”

The proposals fall into three categories:

• Reducing the number of doctors required to comply with a number of sections in the 1983 Act – for example, it will be possible to detain someone in hospital under section 2 or 3 and the courts will be able to send someone to hospital rather than prison if just one doctor says this is right instead of the usual two.
• Extending or suspending time limits that apply to certain actions under some provisions in the 1983 Act – for example the obligation to obtain a second medical opinion about medication when someone has been in hospital for three months or more.

Allowing certain additional people to be approved to undertake some specific functions under the 1983 Act – for example some recently-retired approved social workers may be temporarily approved to undertake the role of the approved mental health professional.

Fast tracked research to fight swine flu

Fourteen projects costing £2.25 million have been fast tracked by the National Institute for Health Research (NIHR) on behalf of the Department of Health for urgent national swine flu research. The priority studies will be launched this week and will provide vital clinical and scientific evidence that will inform the Government’s response to the virus in the coming months.

Results are expected by the end of the year, and will bolster the body of evidence available to experts who advise the Government on how to protect British people.

The work will be led by research centres in Leicester, Nottingham, Newcastle, Edinburgh, Sheffield, Manchester and London.

One study, led by Professor Jonathan Nguyen Van-Tam of the University of Nottingham and the Health Protection Agency, will estimate how long someone is contagious for and advise on a ‘safe distance’ from the patient. This will be done by taking daily nose swabs from those with swine flu over a period of at least one week. The research team will measure how much virus is in the nose and how quickly it disappears. They will also take samples from hard surfaces and the air around the patient. Using this data they aim to work out how much virus is being excreted and whether the virus is more prominent on surfaces or in the air.

The research will be carried out in children as well as adults as children appear to hold on to the virus for longer. The results of this research will be available to the NHS in the autumn.

Professor Jonathan Nguyen Van-Tam said:

“Very little is currently known about the H1N1 virus which makes it very hard to predict the numbers of people likely to catch it and how best to treat them. For example, we do not know how long the virus is excreted by infected humans and how much virus is spread to surfaces and carried in the air.”

Additional research projects have been commissioned into the management and treatment of swine flu. One of these studies, led by Professor Steve Goodacre of the University of Sheffield, is evaluating measures that could be routinely recorded in emergency departments to predict which patients with suspected swine flu should be admitted to hospital.

Other research projects include:

• assessing school closure effectiveness in preventing spread. This would enable local decisions on if and when school closures would be appropriate;
• measuring facemask effectiveness for healthcare workers;
• managing swine flu in pregnant women so that treatment and care gives maximum benefit to mother and baby; and
• how to identify critical care priorities. This will help clinicians make crucial decisions on how best to use resources when treating patients.

Professor Dame Sally Davies, Director General of Research and Development at the Department of Health said:

“We are rapidly learning about the emerging swine flu risk profile - solid clinical and scientific evidence must be at the heart of this.

“The research projects announced today will ensure the UK remains well armed to respond to swine flu, help prevent infection, and save lives.”

Put people ahead of GDP when managing swine flu

The Green Party is calling for Labour to put people ahead of GDP in their plans for managing swine flu.

Joseph Healy, the Green Party's parliamentary candidate for Vauxhall, and the deputy chair of the London Ambulance Service Patients Forum, said:

"In a meeting with the flu planners for London -- which the London Ambulance Service Patients Forum had over two years ago -- we were told that large scale public events would not be closed down because of the economic impact. The chair of the Forum, Malcolm Alexander, and I are due to meet Dr Simon Tanner, the Regional Director of Public Health for London, later today (the 28th of July), when I will be raising more of these issues."

Caroline Lucas, leader of the Green Party, said: "Leading experts are saying that school closures may stem the spread of the disease. If health experts tell us it is time to stop gathering in large crowds, we must heed their advice."

Lucas continued: "If it means that sports fixtures are affected or business conferences don't go ahead, then so be it. The economy may well have to take a temporary hit to stop unnecessary deaths."

The Green Party also wants the government to ensure that people get clear and consistent messages about what they should and shouldn't do during the swine flu epidemic.

Lucas remarked: "The government, by issuing contradictory advice to pregnant women on staying away from crowds was at best unhelpful. If public information is still in a muddle and mess in the autumn, it could lead to many excess deaths."

Large regional variation in number of antiviral collection points

Stephen O’Brien, the Shadow Health Minister, has questioned the Government’s handling of swine flu after data from the Department of Health revealed widespread regional variation in the number of antiviral collection points.

An analysis of the points where members of the public can pick up drugs to combat swine flu shows that in forty-seven Primary Care Trusts there is only one collection point – and in eight, there is no evidence of any collection points.

In contrast, ten Primary Care Trusts have more than thirty.

Stephen O’Brien said, “These figures are a genuine and fair concern and raise further questions about the Government’s handling of swine flu.”

He warned that the number of collection points available in many areas “still seems surprisingly low.”

And he stressed, “If there are areas with too few collection points, then the Government must take urgent action to open more so that people suffering from swine flu can get the antivirals they need.”

PM praises “groundbreaking” swine flu service

A self-care service to help people with swine flu symptoms is “breaking new ground”, the Prime Minister has said.

The National Pandemic Flu Service, consisting of a new dedicated website and phone line, allows people to check their symptoms and, if necessary, get a unique number to allow them access to antivirals from a collection point.

* Visit the National Pandemic Flu Service website

Gordon Brown said the service was already working well to help people get advice as he met NHS staff in London today to hear how the capital is dealing with the outbreak.

He said:

“[The National Pandemic Flu Service] is the first in the world. We are breaking new ground here, but we have been preparing for this for more than two years and I think the evidence is that people are responding to the scheme… What I want to do is ensure that people get the best advice, get it as quickly as possible, are able to get the antivirals when they need them and are reassured.”

The Prime Minister added that he hoped the service would take some of the burden off GPs and hospitals, which have been seeing rising numbers of people reporting symptoms, and he praised NHS staff for their response to the outbreak.

He added:

“I don’t know if any health service in the world could do what we have been able to do so quickly as a result of efforts of all the staff.”

Read advice about swine flu from Directgov

Previous story: Government to increase swine flu support

Tags: National Pandemic Flu Service, NHS, swine flu

National Pandemic Flu Service goes live

Log on to www.direct.gov.uk/pandemicflu or call 0800 1 513 100 or 0800 1 513 200 (Textphone)

New service will relieve pressure on GPs and NHS

A new self-care service which will give people with pandemic swine flu symptoms fast access to antivirals was launched today by Health Secretary Andy Burnham.

The National Pandemic Flu Service is a new dedicated website (www.direct.gov.uk/pandemicflu) and phoneline (0800 1 513 100 or 0800 1 513 200 (Textphone)) for people to check their symptoms and get a unique number which will give them access to antivirals if necessary.

People who have swine flu symptoms will be given a unique access number and told where their nearest antiviral collection point is. They should then ask a flu friend – a friend or relative who doesn’t have swine flu – to go and pick up their antivirals.

The flu friend must show their own ID as well as that of the patient. The authorisation number and ID information will be checked to ensure it matches the information provided when the assessment of symptoms was completed.

Anyone who suspects they have swine flu is advised not to go to their GP or A&E.

People should contact their doctor direct rather than using the National Pandemic Flu Service if:

• they have a serious underlying illness;
• they are pregnant;
• they have a sick child under one year old;
• their condition suddenly gets much worse; or
• if their condition is still getting worse after 7 days (5 for a child).

Andy Burnham said:

“The National Pandemic Flu Service will give patients access to information and antivirals as quickly as possible. It will free up GPs so they can focus their efforts on helping those in at risk groups and patients with other illnesses.

“People can still speak to their GP if they are concerned. In fact - it is important to stress that people with underlying health conditions, pregnant women, and parents with children under the age of one should speak to their GP if they have symptoms.

“For the vast majority of people, swine flu has been mild. Some people find that they get better by staying in bed, drinking plenty of water and taking over the counter flu medication.”

Up to two thousand call operators will be trained for a minimum of three hours. Less experienced call operators will be trained for a day. Strict industry standard regulations are in place when employing staff. These include the right to work in the UK (therefore no illegal immigrants), satisfactory employment references and satisfactory character references.

Doctors from the Royal College of General Practitioners will have a special liaison role with each of these call centres and will feed back problems or concerns that arise during the operation of the service.

As swine flu spreads, it is important to be able to recognise its symptoms. People who have two of the following symptoms and a temperature of 38° C and above or feels hot may have swine flu.

The typical symptoms are:

• sudden fever (a high body temperature of 38C/100.4F or above), and
• sudden cough.

Other symptoms may include:

• headache,
• tiredness,
• chills,
• aching muscles,
• limb or joint pain,
• diarrhoea or stomach upset,
• sore throat,
• runny nose,
• sneezing,
• loss of appetite.

Lansley attacks Labour's "dithering" over swine flu

Andrew Lansley has warned that Labour’s “dithering” over the preparations for swine flu has left the NHS unable to respond effectively to the outbreak.

The Shadow Health Secretary said, “According to the Government’s own planning document, a full National Flu Line should have been up and running over a month ago, and managing the distribution of drugs and information in a coordinated way across the country.”

“Now, as vital weeks have passed and the number of cases has surged, it is clear that the Government’s dithering has damaged the ability of the NHS to respond coherently to the outbreak.”

Andrew stressed there was still “far too much confusion” amongst the public about what to do when people experience flu symptoms.

And he attacked the Government for not taking measures to deal with the expected increase in demand for intensive care beds as the virus spreads:

“The Government now project that up to 1500 extra people a day will need hospital care by the end of August. I can see no evidence that they’ve created the extra bed capacity or trained the extra staff that will be necessary to cope with this sort of demand. This sort of dithering is unacceptable, and does not inspire confidence that Andy Burnham is in control of the situation.”

Lansley calls on Government to resolve swine flu confusion

Andrew Lansley said it is “vital” the Government acts quickly to resolve the confusion around swine flu, after the number of people contacting their doctor increased by nearly 50% last week.

The Shadow Health Secretary stressed, “It is deeply concerning that people are confused about what to do when they experience flu symptoms.”

“It is not helped by the Government’s failure to secure a national flu line when they promised to do so, which would have managed the distribution of drugs and information.”

Andrew called on the Government to implement a national flu line capable of undertaking diagnosis and enabling the collection of anti-viral treatment from a nationwide network of collection points.

He also demanded clarity on when a vaccine will become available in Britain, and asked the Government to publish the scientific advice it has received on priorities for vaccination.

Lansley questions Labour's handling of swine flu

Andrew Lansley has questioned the effectiveness of Labour’s containment strategy for swine flu after it was revealed that surprisingly few anti-virals have been given out.

New information released in response to a Parliamentary Question shows that for 7,447 swine flu cases, only 6,138 courses of anti-virals were distributed.

Although there would have been some cases that were diagnosed too late for anti-virals to be effective, this would have been outweighed by the fact that anti-virals would also have been given to people with suspected - not just confirmed - swine flu.

In addition, anti-virals should have been given to anyone who had been in close contact with a swine flu victim. However, just 10,363 courses of anti-virals have been given out to contacts of people with swine flu – which is fewer than two confirmed contacts of each swine flu victim.

Andrew, the Shadow Health Secretary, said the Conservatives had supported the Government’s containment strategy, but stressed he would have expected all confirmed and suspected victims of swine flu to be given anti-virals, as well as anyone who had been in contact with them.

He described the anti-viral figures as “worrying” and stressed, “(They)suggest that the Government’s containment strategy was not anything like as effective as it should have been.”

(DH) Agreements secured for pre-pandemic vaccine for the UK

Agreements have been signed between the UK Government and vaccine manufacturers to secure supplies of up to 90 million doses of pre-pandemic H1N1 vaccine before a pandemic begins, the Department of Health announced today.

The deals signed between Secretary of State for Health, Alan Johnson, GlaxoSmithKline, and Baxter, will enable production of pre-pandemic vaccine to begin as soon as possible.

The agreements could provide enough vaccine to protect the most vulnerable in our population before a pandemic is likely to arrive, without affecting our supply of seasonal flu vaccine.

Secretary of State for Health, Alan Johnson said:

"The localised cases of swine flu found in the UK have so far been mild, and our strategy of containing the spread with anti-virals appears to have been effective in reducing symptoms and preventing further spread of infection.

"Scientists tell us that as yet we don't know enough about this novel strain, or whether it's likely to mutate, but that this virus has the potential to become a pandemic and we can't predict how serious that would be. We have an opportunity to secure vaccine in advance of a pandemic wave. We have Advance Purchase Agreements to provide vaccine for the entire UK population which will take effect when Phase 6 pandemic is declared. It will then take over a year for all the vaccine necessary to be provided.

"These additional arrangements provide the opportunity by December this year to have enough pre-pandemic vaccine to protect at least half of the population from swine flu. This will however depend on when and if the manufacturers switched from seasonal to H1N1 pandemic specific vaccine production at a time after Phase 6 is declared by the World Health Organisation, as this will take precedence over pre-pandemic contracts."

If a pandemic is declared, Advance Supply Agreements signed by the Government with GSK and Baxter in July 2007, will enable the UK to purchase up to 132 million doses of pandemic specific vaccine, when it becomes available.

(DH) First step towards Swine Flu vaccine prototype achieved

The first step towards producing a European prototype of a swine flu vaccine has been achieved by the Health Protection Agency (HPA), Health Secretary Alan Johnson announced today.

On a visit to the HPA's National Institute of Biological Standards and Control (NIBSC) this morning, Alan Johnson learnt that researchers have sequenced the full genetic code of the virus. This is critical in understanding how the virus operates and identifying the crucial parts of the virus that can be used in vaccine manufacture.

Researchers hope that European manufacturers will be able to take delivery of candidate vaccine prototypes in the coming months so preliminary steps to mass vaccine production can begin.

The NIBSC is the only centre in the UK and one of a handful around the world developing vaccine prototypes for the European vaccine manufacturers. In the US, efforts are focused through the Centre for Disease Control.

In July 2007, the Government signed advanced supply agreements, which will enable the UK to purchase up to 132 million doses of pandemic specific vaccine, when it becomes available. The advanced supply agreements are worth £155.4 million over four years. Under these contracts, GSK and Baxter are committed to supplying a pandemic influenza vaccine as soon as the pandemic strain is identified and made available by the World Health Organization.

The HPA researchers will also work with sister organisations to compare the characteristics of this virus with other samples to gain a greater understanding of how flu infects people and how it can quickly change to evade our immune systems.

Health Secretary Alan Johnson said:

"A significant step towards protecting the world's health against swine flu has been taken.

"The speed with which vaccine prototypes can be created to combat potential pandemics is testimony to the dedication and world-class expertise of Health Protection Agency researchers.

"We have been preparing for the possibility of a pandemic for some time. We now look to the vaccine industry to produce the required quantities of vaccine as quickly as possible."

Professor Maria Zambon, Director of the Health Protection Agency's Centre for Infections, said:

"We are continuing to learn more and more each day about swine flu. The pure sample of virus that we have isolated, together with its genetic fingerprint, will be important resources as scientific organisations join forces on the development of an effective vaccine.

"The rapid assessment of this virus will ultimately help us to make future decisions regarding the health implications of swine flu."

(DH) Public information update from Department of Health

Swine Flu - Thursday 7 May 6pm

A Department of Health spokesperson said:

"Two new cases of swine flu have been confirmed in England today. One new case is an adult from the East of England region who recently returned from the United States. The second is a school-aged child from the London region.

"Both patients have already received antivirals and are recovering at home. Close contacts of these cases are also receiving antivirals as a precautionary measure.

"There are now 34 confirmed cases in the UK - 30 in England and four in Scotland.

"It is right that we are preparing for the possibility of a global pandemic. The UK's arrangements are continuing to ensure that we are well-placed to deal with this new infection."

Further information

If you have flu like symptoms and are concerned, stay at home, if you can go online check your symptoms on the symptom checker on http://www.nhs.uk or call the swine flu information line on 0800 1 513 513. If you have taken these steps and are still concerned call your GP or NHS Direct.

KEY ISSUES

CURRENT SITUATION

* There are now 34 confirmed cases in the UK - 30 in England and four in Scotland.

* The arrangements in place across the UK are continuing to ensure that we are well-placed to deal with this new infection.

* At present, there are 1518 confirmed cases across the world. Twenty-nine deaths from swine flu have been confirmed in Mexico, and two in the US.

* There is not yet evidence of sustained person to person transmission - that is to say, different people in the community who have no obvious link to each other catching this disease.

* Ten people who are not known to have travelled to Mexico have caught the virus in the UK from other infected people who are close contacts. We can reasonably expect the number of such cases to increase considerably over the coming weeks.

* Of the UK cases, 12 are children. Following expert assessment, four schools closed on the advice of local health protection officers in order to contain any potential outbreak.

* A fifth school and a linked nursery decided to close on their own volition after two pupils at the school were confirmed to have the disease, though they had not been at school when symptomatic.

Is it a mild infection and therefore no cause for concern?

* We must not be complacent. It is too soon to assume it will be a mild infection. We don't know the profile of the virus and we are closely monitoring each case that comes up.

* Everyone who has contracted the virus in this country has been diagnosed early and treated with antivirals, which reduce the severity of symptoms.

* The flu virus changes character very rapidly. They essentially evolve with the 'fast forward' button switched on. That means the flu virus is unstable. It can pick up and swap genetic material, which can dramatically change its character - increasing the severity of symptoms. The virus could change in the autumn so we need to plan for all eventualities.

STEPS THE GOVERNMENT IS TAKING TO CONTAIN THE VIRUS

* We know a great deal more about these issues than the governments who had to deal with the pandemics of the last century.

* However, we still don't know enough about the nature of this specific virus. At present, leading scientific experts in this country and across the world are urgently studying who this virus is most likely to affect, whether it will mutate and the possibility of its re-emergence in the autumn as a more dangerous strain.

* While it seems that those who have developed the disease outside Mexico have generally only experienced mild symptoms, there has been a second death in America of a woman who had chronic underlying health conditions.

* The Health Protection Agency and the Scientific Advisory Group on Emergencies, which is jointly chaired by the government's Chief Scientist Professor John Beddington and Professor Sir Gordon Duff (Chair of the Scientific Pandemic Influenza Committee), are clear that it is still too early for confident predictions about the possible severity of this flu in the UK.

* The current containment phase means that all those who contract the virus have been given antivirals to aid recovery, and close contacts - whether they have symptoms or not - are given antivirals prophylactically to reduce their chance of developing the disease and spreading it further.

* This strategy has been adopted because there is good scientific evidence that in the early stages it will stop some outbreaks and delay for as long as possible the establishment of an epidemic.

* However, through this approach, we can only hope to delay a more widespread outbreak, we cannot stop it altogether.

SCHOOLS

* Pupil welfare is paramount. If schools and other childcare settings close at the right time, the spread of infection could be significantly reduced.

* The decision to close a school should be made in conjunction with the local health protection experts.

* For schools that are closed, arrangements will be put in place by Ofqual and exam awarding bodies to ensure that all pupils are treated fairly. These procedures are already in place.

* We recognise the enormous disruption that school closure can cause pupils, parents and staff. Parents should be reassured that the Department of Children, Schools and Families have well-established plans, including procedures to handle any disruption to exams.

PUBLIC INFORMATION CAMPAIGN

* As the World Health Organisation has made clear, one of the critical elements of any country's response to this situation is how the public are kept informed of developments; the steps they can take to protect themselves; and what they should do if they or a family member falls ill.

* A mass public health campaign has begun with print, television and radio advertising.

* Leaflets are being delivered to every home with information about the outbreak and the preventative measures people can take. Recorded information is available on the Swine Flu Information Line (0800 1 513 513).

TAMIFLU

* We currently have treatment courses for around 50 per cent of the population. This is one of the highest levels in the world. The stockpile is being conserved for treatment. We are increasing our stockpile to cover 80 per cent of the population.

* Where suspect cases are being identified, arrangements are in place to ensure between Primary Care Trusts and the Health Protection Unit that tamiflu is made available locally. Health Protection Unit stocks are being replenished from the stocks held by the Emergency Preparedness Division of the Department of Health and stocks are available.

Has the Government banned pharmacists from giving out Tamiflu?

* We have not withdrawn Tamiflu from over counter sales but, because we are increasing our stocks, pharmacists won't be able to buy any more at the moment. Normal supplies of tamiflu in pharmacists are usually relatively small as prescription is normally restricted by NICE guidelines.

ANTIBIOTICS
* We are increasing our stockpiles of antibiotics, which are essential for treating any potential complications caused by swine flu so that we have enough to cover 30 per cent of the population by September.

FLU LINE

* To make sure we can distribute antivirals effectively, we are working to get the Flu line up and running as quickly as possible, and it will be ready by the autumn.

* In the meantime, we are finalising plans for an alternative system that we aim to use in the short term, should the virus become more widespread more quickly.

* The interim arrangements we are putting in place will mean that people with symptoms can be assessed quickly, and antivirals made available so that they can start treatment within 48 hours of symptoms developing. We will co-ordinate local arrangements with primary care trusts for assessment and collection, web access and also the potential for phone services.

* It is critical that any system is robust and as thoroughly tested as possible before it is made operational.

VACCINE

* Scientists are now much closer to developing a vaccine strain from the virus.

* But while the first strain of the vaccine may be ready in a matter of weeks, developing this into a useable vaccine will take several months.

* The UK government and the Devolved Administrations already have agreements in place with manufacturers to supply stocks of a vaccine as soon after production begins as possible. In the meantime, we will continue to get expert advice on what will be the most effective vaccine strategy, and what would best protect us if the virus returned in a more virulent form in the autumn.

* We also need to assess the effects on the availability of the seasonal flu vaccine this winter.

LEVEL FIVE AND PREPAREDNESS

What does level five mean?

* Phase five indicates that WHO considers a global pandemic to be imminent, whereas at phase four a global pandemic is not inevitable. This means there has been person-to-person spread but it is still localised.

* We are still not in a pandemic phase.

Preparedness

* We have been preparing for the possibility of a pandemic for a number of years and are among the most prepared countries in the world.

* The NHS has developed its planning from a national, local and individual level and our plans are robust and advanced.

FACEMASKS

* There is no convincing scientific evidence that the widespread issue of facemasks to healthy members of the public can stop this disease spreading. Moreover, they give can false reassurance, and can encourage people to ignore basic and straightforward hand hygiene measures which have proven effectiveness.

* However, specialist and other types of facemasks are useful for frontline NHS staff who are caring for infected patients, if they are the appropriate type; worn correctly; changed frequently; removed properly; disposed of safely and used in combination with good hygiene measures.

* Although we have a supply of facemasks for NHS staff, we do need more. have ordered an additional 227 million surgical facemasks and 34 million respirators, which, if used properly, can prevent transmission to NHS staff who are in close and frequent contact with patients.

WEBSITES

Key websites

Directgov (http://www.direct.gov.uk/swineflu) the primary government website for essential cross-government swine flu messages; NHS Choices (http://www.nhs.uk) the primary public-facing health information and advice service; the Department of Health website (http://www.dh.gov.uk) the home of content relating to health and care professionals; and Business Link (http://www.businesslink.gov.uk/swineflu) the home of business-related information. The dedicated Swine Flu page on the FCO website is at: http://www.fco.gov.uk/en/travelling-and-living-overseas/swine-flu