Download Health Protection Agency and Public Health ( England)

Health Protection Agency and Public
Health ( England)
Kate James CMCIEH
Specialist Health Protection Practitioner
28 March 2013
Outline of the session
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Health Protection Environmental Health Public Health
What's the difference?
Who are the key organisations?
Where does environmental health fit?
What is happening on 1st April 2013
What is Environmental Health?
Environmental health addresses all the physical, chemical, and
biological factors external to a person, and all the related factors
impacting behaviours.
It encompasses the assessment and control of those environmental
factors that can potentially affect health.
It is targeted towards preventing disease and creating healthsupportive environments.
This definition excludes behaviour not related to environment, as
well as behaviour related to the social and cultural environment,
and genetics.
World Health Organisation
What is health protection?
Protecting the population from infectious diseases
– includes surveillance & contact tracing
Protecting the population from harm resulting from
chemical, poisons or radiation
Preparing for new and emerging threats
Local Authority Proper officer has to notify HPA of any
notifiable diseases in their population. Public health Control
of Diseases Act 1984 as amended and associated
regulations
What is public health?
• Improve health and wellbeing in the population
• Prevent disease and minimise its consequences
• Prolong valued life
• Reduce inequalities in health
Healthcare UK to develop National Occupational Standards for
Specialist Practice in Public Health (2001)
Health Protection in the West
Midlands – March 2013
HPA Food
and water
lab
West Midlands
West HPU
Director: Dr
David Kirrage
Kidderminster
West Midlands
North HPU
Director Dr H
Duggal
Stafford
Chemicals
Division
CRCE
Regional HPA office
Birmingham
Director : Dr Sue
Ibbotson
Regional
Epidemiology
Unit
West
Midlands East
HPU
Director: Dr
H.Mohammed
Health Protection From April 1st 2013
West Midlands Public Health England Centre
Centre structure
Health Protection
Health Improvement
Drugs and alcohol
Healthcare services
Centre Support
Centre functions
Build relationships with
local authorities, provide
professional support
Provide health protection
services
Provide NHS with public
health advice.
Health Protection in PHE
Emergency response- category 1 responder under Civil
Contingency act.
Field epidemiology
Infectious disease surveillance and control
Public Health Strategy
Centre for radiation,chemical and Environmental
hazards
So what do we actually do?
Emergency response
Disease Surveillance
Disease management jointly with EH
Outbreak management
Give expert advice on public health matters. Including
chemical, radiological issues.
Work jointly with acute trusts, EA, LAs,fire brigade,
police, ambulance trust e.t.c on public health matters.
STAC- Strategic
technical advisory cell.
Respond to major incidents by working
together.
Incident Management Team (IMT)
Outbreak Control Team (OCT)
Strategic Coordinating Group (SCG) or Gold
Tactical Coordinating Group (TCG) or Silver
Operating Coordinating Group (OCG) or Bronze
Scientific and Technical Advisory Cell (STAC)
Air Quality Cell (AQC)
Disease surveillance
Epidemiology- Broad Street
NOIDS
The Health Protection (Notification) Regulations 2010
HPA CCDCs either appointed as proper officer by LA or
Proper Officer of LA notifys HPA.
NB- check authorisations as may need to change
documentation to reflect Public health England.
Disease management
West Midlands regional response plan for GI
infections.
West Midlands generic GI questionnaire.
Legionella West Midlands joint plan.
ROLES AND RESPONSIBILITIES FOR INVESTIGATION OF INFECTIOUS/ COMMUNICABLE
DISEASES
West Midlands
This document is intended to provide general principles and guidance for work between
Environmental Health Departments and the Health Protection Agency for the investigation and
management of single cases of gastrointestinal infections.
Other agencies may have roles with regard to specific infections for the investigation and
management of incidents and outbreaks.
In the event that an outbreak is declared the Outbreak Control Plan will then become the document
of use.
The Local Authority has the legal obligation to appoint a Proper Officer for notification purposes
under The Health Protection (Notification) Regulations 2010. The Proper Officer must notify the
Health Protection Agency of any notifiable diseases unless the Proper Officer is an employee of the
HPA.
The Powers to exclude high risk groups from work, etc, rest with the local Authority who can apply
for a Part 2A order under The Health Protection (Part 2A Orders) Regulations 2010.
Time frames agreed in the document reflect expected response times. In specific cases variations
may be agreed between both the HPA and EHO following local discussions and risk assessment of
individual cases and situations and reasons recorded.
It is expected that stakeholders would support essential appropriate investigation and control
actions out of hours when necessary.
Out of hours access to EHO colleagues must be discussed with the consultant on call who will
assess the need based on the risk assessment.
Priority rating for action
High
Initiate contact within 24 hours
Medium
Initiate contact within 3 working days
Low
Inform and advise within 5 working days
E.coli O157 / other VTEC – high priority
Environmental Health Action
Procedure:
Receive information from / liaise with HPU immediately and check
status of lab report with HPU.
Complete National HPA VTEC surveillance Questionnaire either by
phone or personal visit to case and visit any associated premises.
Investigate Food and Environmental aspects - water supply,
drainage, commercial business links, animal attractions, pets,
events etc.
Identify a senior post with responsibility for managing the LAs
participation in outbreaks (Griffin Recommendation 12)
Identify high risk cases and contacts. Advise on infection control
precautions and return to work information.
Follow latest guidelines.
Liaise with HPA regarding exclusion for high risk cases and
contacts
Response time:
Initiate investigation immediately and within a maximum of 24
hours of receipt of notification even on presumptive results, after
discussion with HPU. Support essential appropriate investigation
and control actions out of hours, following liaison with HPA.
Feedback/Actions: Discuss initial risk assessment with HPU
within 24 hours. Report of initial investigation of associated
premises and actions taken to be sent to HPA within 24 hours of
visit. All relevant reports and notices, etc, to be copied to HPA.
Fax questionnaire to HPU next working day – even if
questionnaire incomplete. Completed questionnaire to
be sent within 3 working days.
Health Protection Action
Receive notifications and laboratory reports and
check status of lab report. Patient contact
information to be passed to EHO.
Where required (e.g. where case inpatient or out of
hours) carry out/ensure completion of initial
questionnaire to assess risk factors/exposures –
liaise with EH
Maintain surveillance database.
Liaise with local authorities re case investigation
using National Surveillance Questionnaire (NSQ).
Advise local authorities, GP’s and others regarding
investigation, contacts and exclusion criteria.
Submit completed NSQ to REU and CfI within 48
hours or next working day
Liaise and support health trust colleagues as
required with cases and contacts linked to health
facilities/procedures
Initial investigation needs to be commenced
immediately even if after hours.
Take the lead in co-ordinating investigation and
control of single cases and community outbreaks.
Send any partially completed questionnaires or
further information gathered to EHO.
Outbreak management
Standards for Managing Outbreaks
Standard 1
Outbreak Recognition
Standard 2
Outbreak Declaration
Standard 3
Outbreak Control Team
Standard 4
Outbreak Investigation and Control
Standard 5
Communications
Standard 6
End of Outbreak
The Future
Same but expanding role, different organisations now
in PHE,different name.
Keep in touch with us!