Responders considered that the NHS and HPA response to the first wave of the pandemic had both strengths and weaknesses. Strengths included the familiarity with, and accessibility of, current guidance on the management of people with symptoms of influenza, as well as the ability to obtain antivirals and infection-control advice. Clarity in the information that was provided consistently scored poorly however, and triangulation with free-text comments reinforces that unclear, duplicated, and conflicting information was one of the areas of greatest weakness, as perceived by the GPs surveyed.
The similarity between the scores for information circulated by the NHS and the HPA suggest that neither organisation's guidance was considered optimal by responders. Methods for obtaining PPE and the engagement of GPs in planning for a pandemic were also highlighted as areas of dissatisfaction.
The strong support for the introduction of the NPFS perhaps highlights the intense pressure that some practices experienced during the first-wave response and its effectiveness in reducing demand for consultations as perceived by GPs. Support may also be reflected in activity figures for influenza-like consultations in primary care in the week following its introduction.1
Despite this, reservations were expressed about the safety of the NPFS. Any future deployment of an NPFS-type model to deliver mass assessment and treatment should ensure that high levels of consultation are conducted with GPs to give reassurance about the safety of such a system.
The major limitation of this study is the low response rate. A response rate of over 50–60% is broadly accepted as the level at which the results can start to be generalised.2
As such, it is impossible to generalise these results more widely or draw firm conclusions about the perceived quality of the NHS and HPA response.
There is also the possibility of response bias; people with less-positive experiences are generally expected to be more likely to respond to this type of survey than others. Therefore, it is possible that the whole GP population may have more positive opinions of the first wave than the responding sample but, without conducting a sample of non-responders, this is impossible to quantify.
The responders were, however, representative in terms of their geographical dispersion across the West Midlands and, as such, the level of demand caused by the pandemic in these different areas. This reduces the chance of geographical response bias.
The aim of this study was not to create precise scores for different areas of the response to the pandemic but to highlight areas of performance that could be improved for the future. Despite the limitations described, this is the only published study of GPs' opinions on this topic and will be useful in forming part of a broader assessment of how the NHS and HPA communicated during this pandemic. These results suggest that a particular focus of any assessment should include how the NHS, HPA, and RCGP could disseminate information regarding pandemic influenza, or any other major health threat, in a more coordinated fashion to prevent GPs from being overwhelmed and confused with duplicated and/or contradictory information.