The first UK-wide advice for GPs on infection control in the event of a major influenza outbreak outlines how larger practices might be expected to arrange dedicated teams to treat suspected cases, with separate “flu routes” to ensure they do not come into contact with other patients.

However, it advises that smaller practices, with only one entrance, might have to close their doors to flu patients and have notices indicating alternative places where they could be treated.

Patients could also be asked to wait in their cars until the time of their appointment to minimise contact in waiting rooms. Strict cleaning procedures will have to be employed with soft furnishings, magazines, books and toys being removed .

Doctors are also being urged to consider stockpiling supplies such as masks, tissues and aprons in their surgeries in preparation for a potential flu pandemic.

Earlier this year, the Sunday Herald revealed GPs’ concerns that practices could be inundated by patients in the event of an influenza pandemic and collapse under the demand. In a motion to the BMA’s annual conference of Scottish local medical committees in April, Tayside GP Dr Andrew Buist called on ministers to clarify their pandemic plans as a “matter of urgency”.

Chairwoman of the RCGP in Scotland Dr Mairi Scott said the guidance was the first major piece of detailed advice to start doctors thinking about what preparations they might need to undertake. However, she added that, though the advice was useful, it was not known what form of pandemic GPs might face. “I think it will reassure them [GPs], but who knows what is going to happen ,” she said. “GPs are good at coping with the unpredictable – that’s what it is like in primary care general practice as the first point of contact. Anything can walk through the door.”

The guidelines also contain a detailed checklist of additional supplies that GPs might require to minimise the spread of flu, such as disposable gloves, alcohol wipes, liquid soap and tissues.

While it states that some reserves might be held by health boards or at a national level, it adds: “In the absence of further guidance, practices could consider stockpiling at least 50% of their estimated total pandemic needs.”

The advice has been issued amid fears that the deadly strain of avian flu, H5N1, responsible for more than 100 human deaths worldwide so far, will trigger a global outbreak. In April, a dead swan washed up at Cellardyke in Fife was the first bird in the UK found to be infected with H5N1, although no new cases have been discovered since.

Health minister Andy Kerr acknowledged that effective planning for a flu pandemic required the involvement of primary care providers, such as GPs and local pharmacies. He said: “That is why NHS boards are taking full account of primary care needs in their local planning, and why the Executive has not only been talking to primary care planners at board level, but also talking directly to the Scottish GPs committee.”

11 June 2006