Download Strategic Delivery Plan - Protecting people from infectious disease

21 08
Strategic Delivery
Plan - Protecting
people from infectious
disease and
environmental
hazards
Author: Mark Dickinson, Executive Director of Planning and Performance
Date: 11 December 2012
Version: 0g
Purpose and Summary of Document:
The Public Health Wales Board are asked to approve the Strategic Delivery
Plan for protecting people from infectious diseases and environmental
hazards.
Public Health Wales’ Strategy contains seven strategic objectives, which
are each underpinned by a Strategic Delivery Plan. The plan looks forward
approximately three years and sets out, at a high level, how the objective
will be achieved. The Board approved the first set of Strategic Delivery
Plans in June 2012 and it was agreed the remaining documents would be
submitted once completed.
Sponsoring and presenting Executive Director:
Mark Dickinson, Executive Director of Planning and Performance
Documents attached:

Protecting People from Infectious Diseases and Environmental
Hazards Strategic Delivery Plan
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Date of Board meeting:
20 December 2012
Please state of the paper is for:
Decision
Date: 11/12/12
The Board are asked to approve the Strategic
Delivery Plan
Version: 0g
Page: 2 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Strategic Delivery Plan
Protecting people
from infectious
disease and
environmental
hazards
Lead Authors:
Dr Marion Lyons, Director of Health Protection
Dr Mark Hastings, Director of Microbiology
Date: 11 December 2012
Version: 0g
Purpose and Summary of Document:
The Public Health Wales Strategy contains seven strategic objectives. Each
objective is underpinned by a Strategic Delivery Plan, which sets out, at a
high level, how the objective is to be achieved.
This Strategic Delivery Plan underpins the strategic objective to protect
people from infectious disease and environmental hazards
This plan looks forward for approximately three years, but will be reviewed
at least annually in the light of experience and progress.
Each Strategic Delivery Plan is itself underpinned by more detailed work
plans.
Date: 11/12/12
Version: 0g
Page: 3 of 18
Public Health Wales
1
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Introduction
The Public Health Wales Strategy contains seven strategic objectives, each
of which is supported by a Strategic Delivery Plan. This document is the
Strategic Delivery Plan supporting the objective:
To protect people from infectious disease and environmental
hazards
The plan sets out, at a high level, the approach and key actions that Public
Health Wales will take in meeting this objective.
This plan does not address the Public Health Wales response to
emergencies, which is covered in the Strategic Delivery Plan supporting
the objective “to respond effectively to the public health impacts of
emergencies.
This plan will be revised at least annually and in line with new or changing
priorities as they emerge
2
Context
2.1
The health impact of infectious disease and
environmental hazards
Progress in the prevention, control and treatment of infectious diseases
has considerably reduced their impact on health in Wales in recent
decades. However, infectious diseases continue to evolve and adapt and
remain a significant threat to public health:

healthcare associated infections cause considerable morbidity and
mortality and are a source of great public concern

antimicrobial resistance in key pathogens both in hospitals and the
community is causing increasing difficulty in the reliable delivery of
effective therapy for infections

effective immunisation programmes are essential if vaccine
preventable diseases are to be prevented within the population

some sexually transmitted infections have lifelong consequences for
the individual infected

the potential re-emergence of old threats, such as tuberculosis

the threat of new infections emerging, including those with
pandemic potential

the World Health Organisation has estimated that 24% of the global
disease burden can be attributed to environmental factors whilst at
Date: 11/12/12
Version: 0g
Page: 4 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
the UK level 14% of the burden of disease is thought to be
attributable to environmental stressors

injuries are the leading cause of death amongst under 45 year olds
and the improved control of communicable diseases has led to an
increase in the relative importance of injuries in terms of the overall
burden of disease.
2.2
The Public Health Wales organisational response
2.2.1
Introduction
In responding to these threats, Public Health Wales brings together, in a
single organisation, a unique combination of services and expertise. Two
Divisions have the primary responsibility for action to protect people from
infectious disease and environmental hazards:

Health Protection Division - consisting of the Health Protection
Team, the Communicable Disease Surveillance Centre (CDSC) and
priority programmes

Microbiology Division – consisting of a network of microbiology
services, embedded in NHS hospital locations, together with a range
of specialist and reference services
2.2.2
Health Protection Division
The Health Protection Division has a multi-disciplinary workforce that
includes doctors, nurses, scientists and information staff, all of whom are
supported by core business and Informatics teams. The Health Protection
Division works collaboratively with the Microbiology Division and other
Divisions of Public Health Wales and with partners in Welsh Government,
health boards, local authorities and the emergency services.
The Health Protection Division focuses on the entire population at both the
individual and community level and:

as a single managed service, promotes a consistent Wales-wide
approach to health protection, both within the Division and with
partners

provides advice, support and information to health professionals,
partner agencies and the general public

is responsible for co-ordinating the management of notifiable
diseases, incidents and outbreaks

is responsible for taking forward specific health protection
programmes (Healthcare Associated Infection, Antimicrobial
Resistance, Vaccine Preventable Disease, Sexually Transmitted
Date: 11/12/12
Version: 0g
Page: 5 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Infection and HIV, Blood
Respiratory Infections)
Borne
Virus
and
Tuberculosis
and

is the national surveillance centre for communicable diseases and
environmental hazards

acts on information received from our large network of partners, our
surveillance systems and from investigation and research to reduce
the risk to the people of Wales from communicable disease and
environmental hazards and injury
2.2.3
Microbiology Division
The Microbiology Division is an integrated service within the healthcare
system in Wales and works closely with other divisions in Public Health
Wales and partners in health boards and local authorities. The
management of laboratory services as a co-ordinated network provides a
significant degree of resilience, and capacity, particularly in response to
outbreaks, and ensures standardisation and consistency of service
delivery.
Health Board Services
Medical microbiologists at each site are fully integrated with local services
and provide a comprehensive infection management service. The
microbiology diagnostic services work closely with local clinical and
pathology services. Its key functions are:

laboratory diagnostics to hospitals, general practitioners and other
healthcare providers

advice to hospital physicians and general practitioners on the
investigation , diagnosis, treatment and control of infection

medical microbiology leadership of hospital acquired infection
prevention and control services

support for outbreaks and community infection control

medical and scientific advice and support for microbiologists across
Wales

analysis of food, water and environmental samples with the
provision of official food control support

microbiological services to proper officer and port health functions
National Services
In addition to local services, the Microbiology Division supports healthcare
services across Wales and the UK through the provision of a range of
specialist and reference services. These services provide specialist and
Date: 11/12/12
Version: 0g
Page: 6 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
reference diagnostics, interpretation and expert clinical advice. They
include:

National Anaerobe Reference Unit (England and Wales)

National Cryptosporidium Reference Unit (England and Wales)

National Toxoplasma Reference Unit (England and Wales)

Welsh Mycobacterial Reference Unit (Wales and South West Region,
England)

Welsh Specialist Virology Unit

Specialist Antimicrobial Chemotherapy Unit (SACU)

Welsh Food Water and Environmental microbiology service

Welsh Mycology reference service
The Microbiology Division provides key microbiology and infection
expertise to the Public Health Wales programmes, the Welsh Government
and NHS Wales.
3
Strategic approach
Public Health Wales aims to reduce the impact of infectious disease and
protect the people of Wales from infectious and environmental hazards by:

building on the unique advantages of having health protection,
communicable disease surveillance and microbiology embedded in a
public health system, through a coordinated and collaborative
approach

developing a transparent mechanism for prioritisation of resources
based on burden of disease

providing timely and accurate intelligence to guide health
protection action in support of clear objectives

delivering safe, accessible, responsive, effective and resilient
services of an assured high quality and which are continually
improved

providing training on immunisation to NHS and other providers in
an acceptable, effective and efficient manner (e-learning)

improving service efficiency and effectiveness by exploiting
new technology (automation) and economies of scale

minimising
exposures

adopting an explicit policy of zero tolerance to preventable
healthcare associated infections
Date: 11/12/12
health
impacts
from
Version: 0g
environmental
hazard
Page: 7 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards

harmonising the infection service model and supporting best
practice in infection management across Wales

ensuring appropriate
professionals in Wales

working from and contributing to the scientific evidence
base, including through collaboration in research and development
with other public health agencies and academic institutions

ensuring that the workforce is resilient and has the required
knowledge, skills and expertise to meet current and future
needs

incorporating
appropriate
scientific
and
technological
development into diagnostic services to improve the
identification of infectious disease for the management and control
of outbreaks and enhanced epidemiology and surveillance of disease
antimicrobial
usage
by
4
Specific actions
4.1
Co-ordinated and collaborative approach
4.1.1
Current position
all
health
The Health Protection Division and Microbiology Services work together to
reduce the burden of infection and work closely with partners to achieve
results. With the NLIAH Service Improvement Team (including 1000 Lives
Plus) joining the organisation in April 2013 there is a real opportunity to
capitalise on the organisations assets. Frequently populations that we
need to engage with or services that require support and development are
also targeted by other divisions within the organisation. A joined up
approach in priority areas may result in better outcomes more efficiently
achieved (e.g. reduction in health care associated infections and reduction
in burden of liver disease caused by blood borne viruses, alcohol and
obesity).
Health Protection systems, functions and responsibilities are also changing
and evolving in other parts of the UK. There is a need of ongoing
collaborative working with the relevant public health agencies.
4.1.2
Further actions necessary
1)
Implement The Healthcare Associated
Programme and learn from the experience
2)
Achieve organisational sign up to, and implement, a similar
approach to combat liver disease in Wales, a public health priority
Date: 11/12/12
Version: 0g
Infection
Reduction
Page: 8 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
3)
Further develop links with Health Protection England and other UK
Health Protection Services
4)
Develop specialist and reference unit work plans in line with
National (UK) priorities
4.2
Prioritisation
4.2.1
Current position
The programmes of work currently undertaken have arisen as a result of
many different factors – policy, personal interest, political need etc. As the
burden of disease from all infections/environmental hazards has not been
explored by the Health Protection Division it is possible that we are
neglecting areas where our input may contribute to improved health.
Changes in healthcare priorities, advances in science and technology and
the emergence of new diseases continue to provide challenges and the
stimulus for refocusing service planning and delivery within Microbiology
Services. An ambitious programme of service development and change is
beginning now and prioritisation of resources and effort will be necessary
to ensure delivery to necessary timescales.
4.2.2
Further actions necessary
5)
The Strategic Lead for Surveillance to develop a programme of
inquiry into the burden of disease, the evidence for effective
interventions and their relative cost effectiveness, through
engagement with the wider resources and expertise of Public
Health Wales
6)
Where action for health agreed and extra funding required Board
support to be sought
7)
A service development plan identifying priorities and incorporating
resource mapping and appropriate timescales will be developed
and agreed
4.3
Timely and accurate intelligence
4.3.1
Current position
There are a number of weaknesses in the current surveillance systems.
These include both the quality and timeliness of the data provided to
Public Health Wales and uncertainty as to the value of all of the
information provided to stakeholders by Public Health Wales.
Date: 11/12/12
Version: 0g
Page: 9 of 18
Public Health Wales
4.3.2
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Further actions necessary
8)
Appoint a strategic lead for surveillance
9)
Complete the development of Information Bureau for Infectious
Diseases and ensure resources are available for comprehensive
introduction, implementation and maintenance
10) Agree with NWIS the mechanism for timely access to data from
the Primary Care Data System (audit+)
11) Complete the surveillance review, agree recommendations with
stakeholders and implement them
12) With partner health protection organisations, contribute to a
horizon scanning process to protect from, and anticipate, harm
from infections or hazards
13) Complete and maintain the standard operating procedures for
infection diagnostics across Wales
4.4
Safe, accessible, responsive, effective and resilient
services of an assured high quality
4.4.1
Current position
The response to any notifiable disease, incident or outbreak should be
consistent across Wales and all Wales policies and procedures have been
developed to support this.
For some communicable diseases the burden of disease is considerably
greater in some marginalised groups and the Health Protection Division is
committed to equal access for all.
The Microbiology Division provides routine and specialist microbiology
services through a managed laboratory network, delivered from eight sites
across Wales. The service has CPA accreditation as a network and UKAS
accreditation for its Public Health Microbiology Service (Food, Water and
Environmental laboratories). Microbiology Services are accessible at all
sites 24 hours a day, seven days a week, through a combination of routine
and out of hours service (including on-call), which ensures an emergency
response.
Changes in clinical service configuration across Wales, improved standards
for patient care and the need to respond to new and emerging diseases
requires
development
of
expanded
service
delivery
models
(weekends/bank holidays) that can deliver effective and sustainable
response at all times.
Date: 11/12/12
Version: 0g
Page: 10 of 18
Public Health Wales
4.4.2
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Further actions necessary
14) Deliver a rolling audit programme on the management of notifiable
diseases
15) Audit outbreak and incident responses and ensure lessons learnt
are implemented
16) Build a process for evaluating the impact of interventions into all
work plans and share with stakeholders
17) Reduce the impact of inequalities on access to prevention
initiatives and testing for and treatment of infections. Each
programme to address known areas of inequality and develop
actions for improvement
18) Develop proposals for Public Health Wales to undertake awareness
raising campaigns - for example seasonal influenza vaccination
19) Develop a performance management framework to provide
assurance on safety and quality of microbiology services, including
Standards for Health Services, Risk Register and performance
reports to the Board and Executive Team.
20) Develop harmonised service specifications (including turn-around
times) for all microbiology services, including emergency and out
of hours working
21) Develop plans and implement service change to enable delivery of
enhanced microbiology services (weekend/evenings) necessary for
standardised service specification
22) Build resilience in capacity to provide expert advice and expertise
for development of diagnostic capability in response to emerging
(novel) pathogens
4.5
Training on immunisation
4.5.1
Current position
The Vaccine Preventable Disease Programme provides learning resources
to support immunisation training throughout Wales. These are accessible
through the intranet in the form of documents, presentations and videos.
Scoping the needs of health boards has identified the potential for offering
e-learning to complement current local approaches.
4.5.2
Further actions necessary
23) Work with NWIS and NHS Learning England to scope potential elearning resources for Wales, and develop a costed proposal
Date: 11/12/12
Version: 0g
Page: 11 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
24) Develop and introduce online knowledge assessment tools as an
exit test for immunisation training modules
25) Collaborate with and support health board Immunisation
Coordinators to integrate future e-learning with existing local
provision, including mentorship and monitoring use
4.6
Improving service efficiency and effectiveness
4.6.1
Current position
The Carter report 2008 set out principles and guidance on modernisation
of pathology services in England and Wales. Significant changes in a
number of areas in England have been seen, largely as a consequence of
commercial pressure.
In Wales, the National Pathology Framework defined standards and
provided guidance, while the Future Delivery of Pathology Services in
Wales 2008 gave recommendations for design and delivery of laboratory
services. While much progress has been made in Wales and the
Microbiology Division have led the way, the challenge of introducing
significant service re-design is still to be faced.
Public Health Wales already delivers around seventy percent of
microbiology services in Wales and with the incorporation of Withybush
and Wrexham microbiology services into the network (April 2013) this will
be nearer eighty percent. In addition specialist and reference services are
delivered for the whole of Wales and to the UK.
Following service review consolidation of the laboratories in North Wales
and South West Wales, it has been identified as the only way to ensure
that services can continue to be delivered safely and effectively and be
able to meet the needs of the changing healthcare system.
4.6.2
Further actions necessary
26) Develop and deliver plan for implementation of North Wales
Microbiology Service Review
27) Develop and deliver plan for implementation of AMBU Microbiology
Services Review
28) Develop and deliver implementation plan for incorporation of
Hywel Dda Microbiology Service (Withybush) into Public Health
Wales Microbiology Network
29) Contribute to South East Wales Microbiology Review and support
project to develop options for future service delivery
Date: 11/12/12
Version: 0g
Page: 12 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
30) Review management arrangements and develop structures aligned
with service re-configuration
31) Implement harmonised on call arrangements and develop delivery
plans for all out of hours working
32) Develop common workload measure and standardised pricing
model
33) Lead standardisation and harmonisation of laboratory methods and
clinical practice in Wales
34) Explore commercial partnerships, where appropriate, to develop
opportunities for introducing new technologies
35) Implementation of all Wales LIMS in line with agreed roll out
schedule
36) Replacement of automated AST /ID equipment (Phoenix) to deliver
further improvement in standardisation and detection of antibiotic
resistance
37) Implement agreed expansion of TB laboratory (Llandough) to
ensure specialist services for Wales can deliver enhanced
diagnostics necessary for reducing the effect of Tuberculosis in
Wales
4.7
Minimising health impacts from environmental
hazard exposures
4.7.1
Current position
An Environmental Public Health Strategic Framework and work plan for
2012-2015 has been jointly developed with the Health Protection Agency
CRCE-Wales. This framework has four key aims: to reduce ill-health
associated with environmental hazard exposures, reduce rates of injuries
and associated environmental hazard exposures, reduce health impacts
from environmental incidents and monitor trends and patterns in
environmental public health exposures and concerns. Each aim applies to
key areas of work that cover emergency planning and preparedness,
environmental hazards (air, land, water, nuisance, radiation, housing),
environmental permitting/planning, risk communications, the wider
environment, children’s environmental health, training and education,
research and development and audit and governance. Service delivery and
development are further supported by detailed annual programmes of
work.
Date: 11/12/12
Version: 0g
Page: 13 of 18
Public Health Wales
4.7.2
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Further actions necessary
38) Vision for environmental public health surveillance in Wales to be
developed, to support and inform the ongoing review of
organisational surveillance functions
39) Audit of previous environmental incidents to determine extent to
which ‘lessons to be learned’ have been acted upon
40) Development of performance standards (in conjunction with HPACRCE Wales) to support future audits
41) Development of an Environmental Health Protection Network to
improve communication between central consultants and local
public health teams
42) Develop processes to support a more coherent and coordinated
(national and local) response in relation to Health Impact
Assessment
43) Conduct of a review of where responsibility for implementation of
evidence based injury prevention interventions lies and, where
possible, the extent to which these agencies/authorities are
undertaking this work
44) Development of an education programme to support the reduction
of poisonings amongst 0 to 4 year olds
4.8
Zero tolerance to preventable health care
associated infections
4.8.1
Current position
The Health Protection Division through its Welsh Healthcare Associated
Infection Programme (WHAIP) supports the health boards in reducing the
burden of HCAIs. Considerable reductions in C.difficile and MRSA have
been achieved by health boards in Wales but we recognise that there is
still room for improvement. E coli bacteraemias have doubled in the last 5
years and currently account for approximately 40% of all bacteraemias.
The 2011 Point Prevalence Survey in hospitals in Wales showed that
Surgical Site Infections accounted for 20% of all HCAIs.
4.8.2
Further actions necessary
45) Public Health Wales to consider the reduction of HCAIs a priority
and commit resources from across the organisation to support the
HCAI agenda
46) Develop a Healthcare Associated Reduction Programme bringing
together expertise from all divisions, so that an integrated service
model is achieved and the Health Protection Division can be
Date: 11/12/12
Version: 0g
Page: 14 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
supported in the implementation of good practice and the
evaluation of its effectiveness
47) Discuss with stakeholders at the surveillance review meeting the
role of Public Health Wales as a critical friend
48) Undertake a systematic and scientific root cause analysis into the
increase in E coli bacteraemia in Wales over the last 10 years
49) Develop a comprehensive action plan to tackle Surgical Site
Infections and measure impact
4.9
Harmonising the infection service model
4.9.1
Current position
Infection management services are delivered to hospitals across Wales by
Consultant Microbiologists based at all laboratory sites With the creation of
the new health board structure in Wales, acute hospitals, primary care and
community healthcare have been brought together with the same remit to
reduce infection and the burden of disease in Wales.
This has led to an increased expectation and demand on Public Health
Wales to provide leadership and expert advice and support in a number of
key areas:

appropriate use of antibiotics

infection prevention and control doctor functions

development of infection management algorithms
To meet these demands clinical microbiologists will need to build on
collaborations with health board Infection Control Teams, ensure coordination with other infection management resources (WHAIP/HPT) and
may have to adopt a different approach to delivery of clinical microbiology
services.
4.9.2
Further actions necessary
50) A baseline for clinical services (infection management) delivered
through Service Level Agreements to be developed with health
boards
51) Clinical microbiology services to be developed to reflect new ways
of working (links to workforce development)
52) Contribute to all Wales approach to infection management linked
to antibiotic stewardship
53) Support clinical teams and specialist networks in developing
infection management pathways
Date: 11/12/12
Version: 0g
Page: 15 of 18
Public Health Wales
4.10
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Ensuring appropriate antimicrobial usage
4.10.1 Current position
Work started with All Wales prescribing group to develop an antibiotic
formulary for Wales, anticipated completion August 2013.
Initial work on guidance and model policies for antimicrobial usage in
primary and secondary care begun ongoing programme.
4.10.2 Further actions necessary
54) Ensure high quality antimicrobial susceptibility results are available
55) Develop and implement systems for the effective surveillance of
antimicrobial resistance
56) Utilise the data collected to change prescribing behaviour
57) Develop systems for the prudent use
healthcare, working with 1000 Lives Plus
4.11
of
antimicrobials
in
Working from and contributing to the scientific
evidence base
4.11.1 Current position
The Health Protection and Microbiology Divisions have active and
increasing programmes of research, although to date maximised the
opportunities arising from collaboration with universities and other public
health agencies have not been maximised.
4.11.2 Further actions necessary
58) Develop research approval process in line with overarching Public
Health Wales research structure
59) Form alliances
competencies
with
universities
with
research
skills
and
60) Continue to win external funding for research projects and ensure
that all research undertaken is completed and published
61) Have an annual scientific meeting where research undertaken can
be presented and discussed
62) Specialist and Reference units to build partnerships and develop
research portfolios
Date: 11/12/12
Version: 0g
Page: 16 of 18
Public Health Wales
4.12
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
Ensuring that the workforce is resilient and has
the required knowledge, skills and expertise
4.12.1 Current position
Traditionally Microbiology and Health Protection services have been
delivered largely by highly qualified, knowledgeable and experienced staff
groups.
Within Health Protection this requirement remains but it is believed that
communicable disease will reduce with improvement in the availability and
delivery of health protection interventions such as vaccination and
immunisation. It is anticipated that a shift to a pro-active approach will be
needed with research, planning, education and training being a focus and
the workforce will need to be developed accordingly.
In Microbiology, technological development, standardisation and a change
in ways of working are leading to a requirement for different knowledge
and skill sets, which together with the modernising scientific careers
agenda, provide the catalyst for a new workforce model.
To ensure that an effective, resilient and sustainable workforce is created
and can be maintained, an integrated workforce plan that engages staff
and co-ordinates finance, training and education and Human Resources
will be required
4.12.2 Further actions necessary
63) Ensure that the workforce is restructured in line with revised
development/career pathways and changes in service delivery
models
64) Develop and implement a training and development plan to ensure
all staff have the necessary knowledge and skill to deliver and
maintain services
65) Contribute to the roll out of Modernising Scientific Careers in Wales
4.13
4.13 Incorporating appropriate scientific and
technological development into diagnostic services
4.13.1 Current situation
Molecular (DNA/RNA) based methods for the detection, identification and
typing of micro-organisms that cause disease although still new and
sometimes costly, have become common place in the larger diagnostic
laboratories for the routine diagnosis of common infections.
These
Date: 11/12/12
Version: 0g
Page: 17 of 18
Public Health Wales
Strategic Delivery Plan – Infectious Disease
and Environmental Hazards
methods still have a big part to play in the diagnosis of infection and it
continues to be important to invest in development and optimisation of
these techniques and methods.
However, the ability to determine the whole genome sequence within a
bacteria, virus or fungi, an expensive research function only available in
large commercial or academic institutions, is increasingly being
recognising for its ability to fully characterise an organism and present a
totally new approach to investigation of infectious diseases.
This is still very expensive technology but through commercialisation and
consequential reduction in costs this is now seen to becoming relatively
affordable in the specialist laboratory environment.
The HPA have developed a strategic plan and recently invested heavily in
facilities, equipment, supporting informatics and staffing which moves
their traditional typing and reference services towards genome based
technologies and are developing a bioinformatics infrastructure to support
their epidemiology and surveillance functions. Initial discussions indicate
that this technology has the potential to totally change the way in which
laboratory services function and infectious disease is identified and
managed. The technology and supporting infrastructure requires a
different workforce, facilities and approach to laboratory, epidemiology
and health protection practice.
Public Health
application for
collaboration,
understanding
Wales needs to asses appropriateness and potential
this development within Wales and pursue opportunities for
to gain a better understanding of how it may improve
and spread of disease.
4.13.2 Further action necessary
66) Invest and further develop molecular technology for diagnosis and
management of infection
67) Maintain and build on links with HPA genome project
68) Develop opportunities for collaboration with academic institutions
to demonstrate/determine benefit of genome technologies in
Wales
Date: 11/12/12
Version: 0g
Page: 18 of 18