Sir, as far as we can ascertain there is a lack of information available to dentists on what to do in the event of pandemic flu. We here in Hillingdon have produced the following information and thought that it may be of interest to BDJ readers.

There is much contingency planning taking place in anticipation of pandemic flu.1 Although there remain questions over the timing and the severity, most experts say it is not a question of if but when. Extensive advice for the general public is in preparation, which will include restricting unnecessary travel and gatherings. There is likely to be a certain amount of general disruption. The flu virus is expected to spread mostly through droplets and it is feasible that some people will be infectious before they are symptomatic.2 At the start of the pandemic, there will be no vaccine for protection. In these circumstances, it may not be wise to try to continue with routine non-urgent dentistry, even assuming patients would want to attend. Like many small businesses, GDPs might expect a few lean months.

Other primary care colleagues meanwhile are expecting to be overwhelmed. There will be a national campaign to encourage self-help and using the phone as much as possible for advice. Even so, both pharmacists and GPs may anticipate a huge added burden, not least because of having to deal with all those with non-flu illnesses unable to access their usual hospital care. PCTs are charged with planning for how to cope with the community burden, and are looking for creative solutions for staffing their response, made all the more difficult by staff illness.3

Dental practitioners and their staff have many of the generic skills that will be needed for the clinical flu effort. There are the basics of record-keeping, dealing with the distressed public, confidentiality and infection control. GDPs also have prescribing powers without needing to use the PGD (Patient Group Directives) planned for other groups. When debating this locally some years ago, there was an outline agreement with the LDC that dentists would be encouraged to volunteer to make themselves and their staff available to help out their medical colleagues. This may be to help staff flu treatment centres, or help fill backroom roles in general medical practices.

Suggestions are needed for the best ways of achieving this for those dentists that are willing, recognising the flexibilities in the new dental contract. This may need to be facilitated by the centre and implemented locally, in discussions between the LDC and PCTs. In return for being part of the pandemic flu emergency primary and community care workforce, the system would need to ensure dentists continue with their remuneration, get temporary relief from their targets and have any indemnity issues covered. Ready-made templates for delivering this package already agreed with the profession would help local planning.

We are confident that many dental practice staff will want to show their professionalism and rise to the occasion rather than hibernate for the duration.