Pandemic Flu: A Scottish framework for responding to an influenza pandemic

11 COMMUNICATION AND PUBLIC ENGAGEMENT

11.1 Current perceptions and understandings

Preparing for, responding to and recovering from an influenza pandemic will depend significantly on co-operation between the Government, public authorities, business, non-governmental organisations, the voluntary sector and individuals. An effective two-way communication strategy that positively engages each of these key groups prior to and during a pandemic is therefore a major strand of the Government's preparations. Any emergency on this scale also needs strong national direction of public information from the outset. Timely advice and information will help prepare the population for the potential impact of a pandemic and will be critical to its subsequent management.

Research commissioned by the Department of Health ( DH) suggested that the general level of awareness and understanding of influenza amongst health professionals and the public is very limited. Influenza itself is not generally regarded as a serious illness except by those within traditional at risk groups and there is general confusion between antiviral medicines and vaccine, and their availability for treatment. 'Bird flu' is frequently confused with pandemic influenza, making pandemic communications prone to misinterpretation and it is widely assumed that effective medical countermeasures will be available. Media information was perceived as sporadic, inconsistent and not associated with communications from Government (even when Government spokespeople are quoted).

11.2 Aims and objectives

The main aims of the UK Government's communications and public engagement strategy are to:

• improve general awareness and understanding of influenza amongst the population and promote good hygiene and other general precautionary measures
• prepare the country for the probable emergence of a new or re-emerging influenza virus and explain what is being done to detect any such virus and prevent its spread
• achieve public support for national response and contingency measures
• explain the uncertainties and what can be done by government as a whole, the NHS, other organisations and individuals to reduce the impact of a pandemic and some of the constraints that entails
• encourage discussion of pandemic response options, limitations and constraints in an inclusive and transparent way
• mobilise the population as partners at the response phase
• convey accurate, timely, consistent and credible advice and information to the public (including all hard-to-reach groups), professions and businesses at the response and recovery stages
• provide advice and information for travellers and UK citizens overseas and for foreign residents and visitors in the UK
• provide specific advice on response strategies and tactics as the actual characteristics and impact of an emerging virus are identified
• provide multilingual information on how assessment, healthcare and other support services should be accessed by symptomatic patients
• encourage the continuity of normal and essential activities as far as possible
• uphold the rule of law and democratic process
• promote individual and social responsibility
• address the needs of all groups.

During the inter-pandemic period, the main objectives are to provide accurate advice and information, encourage the adoption of high standards of personal hygiene and prepare the population for the emergence of an influenza pandemic and its potential impacts. During any period of increased alert and throughout the response phase, the objectives are to promote and reinforce individual and collective actions that reduce the spread of influenza and minimise its health and wider impact on the UK.

11.2.1 Key elements

The key elements of the Government's communication and public engagement strategy are:

• encouraging prior public debate to explore the ethical, professional and practical implications of an influenza pandemic, condition public expectations and ensure that decisions are made in an inclusive and transparent way
• active media engagement to ensure that timely and accurate information and technical explanations are available to support informed reporting
• provision of open access to various direct sources of accurate and current information such as telephone helplines and websites
• research and pre-testing to identify communication priorities and to ensure that messages are clear, effective and meet public needs
• multi-media and multilingual public information campaigns delivered directly and/or through healthcare and service providers
• specialist advice and information for particular settings and sectors
• clinical information to support healthcare professionals in primary and secondary care
• rapid information sharing within and between all sectors.

11.3 Government News Co-ordination Centre and SEER

The UK Government's News Co-ordination Centre ( NCC) is set up to manage the communications aspects of a crisis, major emergency or other disruptive challenge. In any period of increased alert and during a pandemic, the NCC will become operational in support of DH as the lead government department and will work to the policy direction of the Cabinet Office Briefing Room. A government media centre will also be established.

In Scotland, the Scottish Executive Emergency Room ( SEER) will be activated, and will coordinate information from UK and regional Scottish levels. This will include preparing briefings for Scottish Ministers, national situation reporting and acting as an information point for Scottish media inquiries.

11.4 Cascading information

DH will inform the Scottish Government of any changes in the World Health Organization pandemic phases. The Cabinet Office will work with DH to develop, update and circulate top line briefings via the News Co-ordination Centre. In Scotland, SEER will cascade information to NHS Boards and to other organisations via the eight regional Strategic Coordinating Groups. Communications of clinical information to Scotland's NHS Boards would be via the Chief Medical Officer ( CMO) network. Other Scottish Government directorates will arrange sector-specific briefings.

Foreign nationals visiting or resident in the UK should maintain contact with their respective Embassies, which should have regular briefings, advice and information from relevant government departments/directorates.

11.5 Health communications

The communications plan for Scotland supports the UK Framework and recognises that DH has the overall UK lead. DH will be the primary source of health related messages and will work closely with all four health departments/directorates, the Cabinet Office, other government departments/directorates, the Health Protection Agency and Health Protection Scotland to deliver a nationally co-ordinated communications strategy.

Effective internal two-way communication will also be vital to an effective response in a pandemic and regional Strategic Co-ordinating Groups will play a key part in linking to health services and will support and co-ordinate the activities of local NHS Boards in delivering locally tailored press notices, key fact sheets and identifying suitable spokespersons.

All mainstream information and campaign materials need to be accessible to the widest possible audience, including all hard-to-reach groups. Explanatory leaflets, a guide explaining pandemic influenza and other informative material is already available on the Scottish Government Avian & Pandemic Flu web pages: ( www.scotland.gov.uk/pandemicflu) Information leaflets have been distributed to GP surgeries, pharmacists, and NHS 24 call centres and walk-in centres. Plans for a print and broadcast advertising campaign and a public information film have also been developed and will be held on standby. A national leaflet door drop will be activated at WHO Phase 5.

The CMO will have an important professional leadership role in a pandemic. In conjunction with expert groups, professional bodies and Health Protection Scotland, the CMO will provide multidisciplinary advice and information and may need to adapt initial guidance as the characteristics of the emerging influenza virus become more apparent or if pressures on capacity, pharmaceuticals or other supplies make tactical changes necessary.

11.6 Telephone advice and access

The Government will make public information, advice, access to literature and daily situation reports updates (in real time to ensure that the right message is communicated at the right time) available from WHO phase 5 through the national influenza line service (see also section 9.8.5).