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MANAGING INCIDENTS PRESENTING ACTUAL
OR POTENTIAL RISKS TO THE PUBLIC HEALTH:
Guidance on the Roles and Responsibilities of Incident Control Teams
INTRODUCTION
On a day to day basis, we all come into contact with a variety of situations which may cause us harm. Individually and collectively we can take measures to prevent this occurring. Circumstances can arise, however, when the health of sections of the population can be put at risk because they are being or are likely to be exposed to higher levels than normal of a harmful substance or germ. In these situations additional controls need to be put in place and/or services must react to a surge in demand. These are public health incidents.
NHS Boards are accountable to the Scottish Executive Health Department (SEHD) for protecting and improving the health of people of people living within their geographic areas. This involves working in close partnership with local authorities and other agencies. This guidance provides a framework for how NHS Boards should discharge these functions in relation to incidents presenting actual or potential risks to the public health.
NHS Boards discharge their responsibility for the protection of human health during incidents and outbreaks within the context of shared responsibility for improving health with local authorities and overall emergency planning arrangements. With regard to the latter, the principal resource document for civil contingency planning in Scotland is the Scottish Executive's "Dealing with disasters together". This document stresses the need for "Integrated Emergency Management" (IEM) and this is reflected in the guidance provided here. Further guidance on these on these is provided in "
NHS Scotland - Responding to Emergencies".
This document should be regarded as a reference document for developing integrated local public health incident response plans and procedures. These local plans should be drawn up under the general direction of the NHS Board in close collaboration with local authorities and local emergency planning co-ordinating groups.
Background
This overall guidance, applicable to all types of public health incidents, was requested by the Ad-Hoc Group of Ministers on Health and the Public Water Supply. In addition to the issues raised in the incidents involving cryptosporidium and the public water supply to Edinburgh and Glasgow in August 2002, it takes into consideration:
the guidance to help plan the health service response to the deliberate release of biological and chemical agents in Scotland issued in May 2002;
the revised guidance on the investigation and control of outbreaks of food-borne disease in Scotland, issued in August 2002;
the recommendations of the Fatal Accident Inquiry into the outbreak of
Clostridium novyi in injecting drug users in the West of Scotland issued in February 2002;
the recommendations of the Expert Group which reviewed the circumstances surrounding the onset of the outbreak of salmonella infection at the Victoria Infirmary, Glasgow, issued in October 2002.
This document deals with the generic organisational arrangements and main functions involved in handling incidents or outbreaks involving actual or potential exposures to a range of hazards, and in particular the roles and responsibilities of incident control teams (ICT). SEHD has issued guidance on the investigation and control of a range of specific public health incidents and outbreaks. These are summarised in
Annex 1. This guidance builds on the principles laid out in these documents. Specific issues related to incidents involving chemical and radiation are presented in the Annexe
2 and
3. These annexes update annexes J and M of "
NHS Scotland - Responding to Emergencies". In response to the recommendations made in the report of the expert group which recently examined the management of the outbreak of hospital acquired infection (HAI) at the Victoria Infirmary Glasgow,
Annex 4 outlines roles and responsibilities regarding the management of outbreaks of HAI occurring in NHS settings.
As defined in the next section arrangements NHS Boards are required to have in place arrangements to deal with outbreaks and incidents, be they of accidental or deliberate causation. Unless otherwise indicated, the term incident is used to cover all these eventualities in the following text.
Consultation
This guidance should be regarded as a reference document for developing integrated local public health incident response plans and procedures, and for handling any future outbreaks or incidents. However the Executive recognises that its publication will stimulate consideration and discussion if the issues. As such, all recipients are invited to submit comments on the guidance to:
Sandra Smith
Public Health Division
Scottish Executive Health Department
Room 3E(S)
St Andrew's House
EDINBURGH
EH1 3 DG
E-mail -
sandra.smith@scotland.gsi.gov.uk
The deadline for this consultation is 30
th May 2003.
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