Managing pandemic influenza in general practice

A guide for preparation, response and recovery
7.4 Business continuity
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7.4.1 Managing the workload

Workloads may change dramatically during a pandemic. At the start of and throughout the pandemic, practices may need to revise what work will be done in the practice and what work will be re-organised, delayed, shared or referred. Key tasks for all staff should be prioritised and any additional workforce capacity available should be identified.12 Revise your practice’s triggers for shutting down operations.

Home visit demands could increase (for patients in quarantine and patients with chronic illness) and practices will need to ensure sufficient resources are allocated to meet demand while protecting staff and patients. Where travel restrictions or fuel shortages are an issue, consider the use of alternative techniques such as phone, video or online consultations.

Where possible, practices may consider sharing the workload with other local practices. One practice could be designated for management of patients with fever and those with an influenza-like illness, and other clinics manage patients with a non-infectious illness.50 Where they operate, flu clinics may help reduce numbers of emergency department visits,51 although they may have limited impact on general practice workload.

7.4.2 Human resources

Review your human resource management plan in light of available pandemic information. Depending on the nature of the pandemic (ie. who is at most risk, morbidity and mortality rates), likely demand for services and practice circumstances, practices may need to update their plans.

Practices may consider assigning a dedicated staff member to oversee work rosters and manage risks to staff health and wellbeing. Medical staff may have a higher infection rate than the general population. Infection of staff may lead to further infections of their family members. In a ‘mild’ pandemic (in terms of mortality such as experienced in 2009), there may be little absenteeism. However, when faced with a ‘severe’ pandemic, staff who elected to work during planning may decide not to risk their and their family’s health.

If a surge is expected and additional staff are required (including volunteers), contact your indemnity insurer for temporary coverage of GPs and staff members.

All practice team members must be aware of the practice’s pandemic plan and have received training appropriate to their roles. Lack of knowledge of the pandemic plan has been associated with work avoidance.38 Let staff know that the plan is flexible; for example, for staff members who agreed to work during planning but now feel the risk is too high, alternative arrangements can be offered such as visiting the ‘well’, only managing injured patients or those with non-communicable disease, or working from home.

If the response to the pandemic requires staff to work more hours than usual, consider reducing exhaustion and burn-out by having shorter, more frequent shifts or having longer shifts with more time off in between.

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  2. Devnani M. Factors associated with the willingness of health care personnel to work during an influenza public health emergency: an integrative review. Prehosp Disaster Med 2012;27:551–66.
  3. Lee A, Chuh AA. Facing the threat of influenza pandemic – roles of and implications to general practitioners. BMC Public Health 2010;10:661.
  4. Hall GG, Perry AG, vanDijk A, Moore KM. Influenza assessment centres: a case study of pandemic preparedness to alleviate excess emergency department volume. CJEM 2013;15:1–8.