Health Board Health Protection Dr Jackie Hyland NHS Fife
Jan 01, 2016
Health Board Health Protection
Dr Jackie HylandNHS Fife
Communications
What are we trying to do?Form Follows Function
UK Models England
•Fewer CCDC/head of population BUT
•CCDC job is different •PCT i.e Imm Co-ord, Flu co-ordinator, Emergency Planning etc •Not involved in Hospital Infection control• Data is much better in Scotland. Some good things - some HPUs have EHOs on staff working as HP practitioners alongside nurses. At least one HPU post Godstone now use HPU staff to interview serious GI illness e.g. E coli i.e similar to what we do in Grampian.
Wales? N Ireland?
re
Environmental Public HealthParadigms & Practice
BIOLOGICALCHEMICALRADIATIONPHYSICAL
AIR (Inhalation)
WATER (Ingestion)FOOD (Ingestion)
PHYSICAL CONTACTIRRADIATION
CHILDRENPREGNANT WOMEN
ELDERLYSOCIALLY DEPRIVEDRURAL COMMUNITIES
ENVIRONMENTAL HAZARDS
EXPOSURE ROUTES
POPULATIONSAT RISK
OPPORTUNITIES FOR HEALTH PROTECTION INTERVENTION
SOURCE PATHWAY RECEPTOR
ELIMINATE HAZARDS
AT SOURCE
PREVENT ENVIRONMENTAL CONTAMINATION
PREVENT EXPOSURE VIA
CONTAMINATION PATHWAYS
PERSONAL/ POPULATION PROTECTIVE MEASURES
CONTROL CONTAMINANT
LEVELS
Ref. Dr. C Ramsay
How do we protect health? Refhttp://www.sehd.scot.nhs.uk/cmo/CMO(2007)02.pdf (accessed 07/05/09)
1. SurveillanceMonitor the health of the population and the hazards
and exposures affecting it.
Outcome 1 – The HP Team is able to collect and analyze data for surveillance purposesStatutory notifications, laboratory results of statutory notifiable diseases, immunization data, environmental public health data
Outcome 2 – The Health Protection Team regularly reviews data with relevant colleagues (ie at meetings, through reports)Chest Physicians (TB), GUM Physicians,Environmental Health officers, other serviceproviders as appropriate.Circulars/newsletters to local GPs etc
New and Renewed Threats• New (H1N1, iGAS, PVL MRSA), renewed (measles, TB)• Increase temperatures – vector borne diseases e.g. malaria• Flooding and drought• Post September 11th 2001 deliberate releases/bioterrorism• Insufficient control measures (imported food, health screening)
2. Investigation Investigate why and how people fall ill because of
exposure to hazards and what can be done to prevent this.
Outcome 3 - The Health Protection Team has capacity and expertise to provide support to priority areas of workE.g. Pandemic influenza; healthcare associated infections and antimicrobial resistance; vaccine preventable diseases and the impact on them of current and planned immunization programmes; environmental exposures which have an adverse impact on health; gastro-intestinal and zoonotic infections, hepatitis C and other blood borne viruses etc.
3. Risk Assessment)
Estimate the probability of the health of a community being damaged from exposure to a hazard.
“Bigger units means becoming call centres, withdrawn, losing local relationships with local authorities and other partners. No longer able to proactively raise awareness to support implementation of polices. No longer able to visit cases or sites. LA going own way losing co-operative approach.” CPHM
4. Risk ManagementPut in measures which reduce the risk of exposure to
hazards and the impact they have on health.
Outcome 4- The Health Protection Team is able to ensure that policies are regularly updated and reviewedSchools/Nurseries/childminders, Residential homes, TB, Pandemic Influenza plan, Meningitis, Infestations (Headlice/Scabies), Blood borne viruses, Emergency Incidents, Other policies relevant to Board
5. Risk communicationInform the public about the risks to their health and what
the individually or collectively can do to reduce these
Communication which is proportionate!
Outcome 5- The Health Protection Team is able to deal with out of hours incidents, outbreaks and emergency incidents. Production and regular update of on-call pack, Regular training for staff participating on on-call rota, Organisation or participation in table top simulation for exercises for Communicable Disease outbreaks , Other incidents (water borne, CBRN, air borne and radiation)
6. Emergency response and management
Respond to incidents and outbreaks so as to reduce the number of cases of illness and other consequences to a
minimum
• Outcome 6 - The Health Protection Team is able to maintain health protection skills and competenciesEmergency Incident Management, Media handling, Legal aspects of Health Protection, IT/Epidemiological techniques
• Outcome 7 - Health Protection Team is able to attend professional meetings to monitor and influence service developmentsLocal Immunisation meetings, Hospital Infection Control meetings, Emergency Planning meetings, National CDEH meetings, National Health Protection Conferences
• Outcome 8 - The Health Protection Team is able to participate in educational/audit activitiesParticipation in local/national audit/ surveys, Fulfilling own professional CPD requirements, Training of on-call staff, Training local colleagues/professional groups in aspect
• Outcome 9 - The Health Protection Team has the capacity and resilience to respond to individual reports, incidents and outbreaks in line with national and local guidanceCapacity and resilience issues picked up in Joint Health Protection Plans
• Outcome 10 - The Health Protection Team is well led Vision, values and aims shared by team, Health Protection team works well together , Health Protection team uses resources efficiently, Team members maintains good partnerships with local and national NHS colleagues and with local authorities
Main work-streams
Reactive - Stakeholder driven - operational response focus- non-negotiable e.g. chemical incident response
Proactive -- driven by Stakeholder perceptions of key issues- differing Stakeholder priorities and demands – competing
some
Maintaining a Balance- dependent on whose “priorities” weight greatest and the
availability of resources
Environmental Public Healthand Communicable disease Control
adapted from Dr C Ramsay presentation
Thank-you
Acknowledgements
David Breen
Helen Howie
Jayne Leith
Ken Oates
Tim Patterson
Colin Ramsay
Diana Webster