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Lincolnshire Pandemic Flu Communications Workshop

February 2009

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Peter Richardson,Emergency Preparedness Trainer,NHS Lincolnshireon behalf of:

Stuart Northolt Department of HealthNHS Implementation Communications Manager

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Research provides us with several insights…

There is very little, if any, awareness or understanding of pandemic flu

There is a lack of confidence in Government messaging Friends, family or trusted members of their community likely to be

initial source of advice Many people will act in their own self-interest A significant proportion of the population is likely to panic

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measured engagement’

‘Measured Engagement’– Timely – Information appropriate to the level of risk– Relevant but not panic-inducing– Responsive

The overall challenge for communications

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The WHO phases provide a framework for communications:

WHO 3 WHO 4 WHO 5 WHO 6

Rare human cases, no human:human

transfer

Small outbreakslimited human:

humantransfer

Larger outbreakshuman: human

transfer established

Pandemic confirmed

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Research has identified that each stage is associated with a different mood:

6

WHO 3 WHO 4 WHO 5 WHO 6

‘Vague worry’ ‘Alarm bells’ ‘Air raid siren’ ‘Panic stations’

Proper fear sets inPanic-driven behaviour

changes, especially when threat is local

Rumours and scaremongering

‘ruthless’ creativity tocircumvent system

Hunger for informationSuspicion of Govt

approachThreat becomes real for

many

Many will remain unconcernedif flu outbreak in Asia Active info-seeking

from concerned panickersExaggeration and

misrepresentation of threat and how to control it

Little knowledge but much confusion re

types of fluVocal ‘experts’ inform

opinionRemote concern

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Respiratory and Hand Hygiene

19 April 2023

7

2007 Media Activity: Bus panels, Tube and train card panels, Supermarket 6 sheetsScreensavers in Offices

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Dirty Bertie

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Managing public (and internal) messages

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Manage the Pandemic

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Comms Strategy by phase:

19 April 2023

11

WHO 3 WHO 6WHO 4

Building good RHH behaviours

WHO 5

Making the link with Pan Flu

Getting the nation ready

Managing the Pan Flu crisis

NHS Number Awareness & recruitment – PCT rollout

Pan Flu education, advice & measures

Advice remindersPan Flu updates

Automated information line & digital strategy

National & local media briefings

Govt News Coordination Centre

Automated information line &

digital strategy

RHH AdvertisingDoor Drop 1

Stakeholder & media engagement

RHH PR

NHS Number Awareness & recruitment – PCT pilot

National broadcast paid & unpaid channels

Door Drop 2

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NHS Communications SHAs and local NHS Trusts are responsible for

managing the local communications response to Pandemic Influenza-related healthcare issues.– Provide local support and reinforcement to overall strategic

initiatives, eg:• RHH• Door Drops• Pandemic Flu Information Line• National Pandemic Flu Line Service• Collection points

– Internal communications: provide advice, support and information to staff, primary care contractors and other partners

– Collect, collate and disseminate information on the local health situation

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The communications planning structure

National (DH and contingency) plans London Health Community

Pandemic Flu Communications Framework All local Trusts need to update/write the Pan Flu

communications plans

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NHS staff are people too

Public concerns coming out of research Same concerns as being expressed by NHS

professionals– Eg National Pandemic Flu Line Service– Contradictory messages– ‘Internal’ comms the most difficult part of the comms mix

Follows that if we can put in place comms measures that reassure the public, we’re also building confidence among our own people – and vice-versa

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Flu Line patient pathway

UK Operating Services1. ENGAGES: Individual (or representative) contacts FluLine

2. VALIDATE ID: Individual provides health number

3. CONDUCT ASSESSMENT: Individual’s eligibility to receive Antivirals for treatment is assessed

4. AUTHORISE COUNTERMEASURE: Individual is given URN and collection information

FluFriend

6b. DELIVER TO INDIVIDUAL: FluFriend delivers Antivirals to Individual

Stan

dard

Indi

vidu

al P

roce

ssFluLine FluLineFluLineFluLine

Stan

dard

Sup

ply

Proc

ess

2. CHECK ORDER: Order is accepted, rejected or adjusted locally

PCT Co-ordination Centre

3. VERIFY ORDER: Order is accepted, rejected or adjusted nationally

National Co-ordination Centre

4. RECEIVE ORDER: Orders are received and consolidated

5. PICK, PACK & SHIP: Stock is selected, packed and transported

6. CONFIRM RECEIPT & PUT-AWAY: Stock is received, reconciled with order and stored

Collection Point Collection Point

FluFriend presents URN to collection point on behalf of Individual

5. ISSUE: Antivirals are issued to FluFriend on behalf of Individual

Collection Point

3rd Party Supplier

3rd Party Supplier

COMMUNICATIONCOMMUNICATION DECISION-MAKINGDECISION-MAKING

SURVEILLANCE & MONITORINGSURVEILLANCE & MONITORING

Individual receives URN

INTERNATIONAL LIAISON: Provides/receives international status information and maintains WHO phase specific algorithm

MONITOR IMPACT: Predicts future cases and their geographic spread. Assesses clinical severity and informs policy on managing complications

MANAGE STRATEGIC SUPPLY: Monitors efficacy of clinical countermeasures involved in Response. Monitors depletion and recommends changes to distribution protocol

= External Interface

WHO

MONITOR HEALTH AND SOCIAL CARE PRESSURES

Nurse supports Contact Centre Agents with queries

Real-life modeller

Real-life modeller

HPUs, ONS

MHRA

6a. UPDATE STOCK POSITION: Stock levels are updated

Collection Point

1. PLACE ORDER: Order is placed based on minimum stock threshold and volumes issued

Symptomatic Individual

Stock Tracking Capability

Nurse supports Contact Centre Agents with queries

HPA

HPA

HPA

Communications Pre Pandemic

Approach

NHS Implementation Pre Pandemic

Approach

Social Care Pre Pandemic

Approach

Pre Pandemic During Pandemic

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eg: challenges for mental health patients High level of anxiety Reliance on consistency

– Eg regular counsellor, therapist– How communicate that regular carer may be ill?– How communicate in actuality of carer being ill?

Poor uptake of medication– Will they take antivirals?– Poor ability to self-care

Effects of Pandemic Flu– Threat– Actuality– Enhanced anxiety/depression/self harm– Longer-term depression and other health consequences?– General rise in mental health vulnerability?

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Can we use stakeholders to support Pandemic Flu communications? Pro-actively encourage people to become ‘Flu Friends’

to vulnerable patients? Issues around advocates and advocacy? Piggyback on the specialist communications channels

used by service providers?– eg MIND– MHF– Shelter– Learning and behavioural disabilities charities

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The communications planning structure

National (DH and contingency) plans London Health Community

Pandemic Flu Communications Framework All local Trusts need to update/write the Pan Flu

communications plans

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Pandemic flu Communications Plan FOR THE

LINCOLNSHIRE HEALTH AND SOCIAL CARE COMMUNITY

‘healthcare staff are an important sub-set of the general public and with the right information, can become trusted ‘ambassadors’ carrying key messages to their families, friends and communities. *

*(WHO Level6)

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How might the info be communicated to staff?

Depends on Alert level; face-to-face briefings may not be a good idea during a pandemic event ! But, as an example, staff induction provides an opportunity for basic awareness raising

During a higher Alert level there are many everyday tools that could be employed: The Telephone! Email, Shared computer folders, Intranet, Extranet, Payslip messaging…

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Pandemic flu Communications Plan FOR THE

LINCOLNSHIRE HEALTH AND SOCIAL CARE COMMUNITY

‘The General Public will continue to be informed and educated through published materials and use of the media…

‘A local helpline will be established, as needed, to supplement the resources of NHS Direct and the National Flu line service.’*

*Source: Pandemic flu Communications Plan FOR THELINCOLNSHIRE HEALTH AND SOCIAL CARE COMMUNITY, Draft 1,November 2008 (WHO Level6)

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WHO Level 6 Communications outcomes People understand the gravity of the

situation People know what to do to reduce the

risk of infection or how and where to access help and treatment if they are ill

People know how to access Flu Line services

People know to limit their visits to GPs, hospitals etc

Burden on NHS through public use of inappropriate channels (whether intentional or accidental) is reduced

Staff morale maintained Staff absenteeism though fear of

infection kept to minimum