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Health Protection in Scotland - A Consultation Paper

Chapter 7: Conclusion

This Chapter draws together the various questions posed in preceding chapters on which it would be helpful to have views. They are:

What is health protection?

It would be helpful to have views on:

• the scope of health protection in Scotland and how that might support our established commitment to working within a UK and increasingly international context.
• how the contribution of local authorities and EHOs in particular to health protection might be enhanced.

Do consultees agree:

• that consideration of change should focus on the functions discharged by:
• National Radiological Protection Board;
• National Focus for Chemical Incidents;
• Scottish Centre for Infection and Environmental Health;
• Information and Statistics Division (the health surveillance elements);
• Scottish Poisons Information Bureau;
• Scottish National Reference Laboratories;
• NHS Boards (health protection functions).
• that EHOs should not be considered for inclusion in any new organisational arrangements for health protection?

Major issues for health protection in Scotland

Do consultees agree that the health problems detailed in chapter 3, are major issues for health protection in Scotland?

Could consultees indicate any other health problems, which they consider to be major issues for health protection, and give the reasons why.

Strengthening health protection services

Do consultees agree that health protection requires strengthening in the following areas:

Surveillance

• Monitoring unusual illnesses or syndromes
• Integrating different surveillance systems
• Modernising the system for notifying communicable diseases
• Improving information technology for data transfer

Investigation

• Improving capability to carry out investigations into outbreaks or incidents
• Defining strategic priorities for research into health protection issues
• Making better use of the findings from investigation and research

Risk Assessment

• Continue to develop guidance on good practice in risk assessment in health protection agencies, particularly those working within the NHS;
• ensure that all policies developed to protect the public are formally founded on a rigorous approach to risk assessment.

Risk Management

• Partnership working on health protection
• Education on hygiene
• Development of indicators to assess the performance of NHS agencies with health protection responsibilities and the impact of risk reduction measures on health

Risk Communication

• Developing guidance on risk communication for NHS agencies involved in health protection to be used in establishing communication plans and procedures.
• Commissioning research into understanding how certain risks become amplified and how the public can develop better means of comparing and contrasting risks which affect their personal life (risk literacy).

Emergency response and management

• Carrying out more regular joint exercises in all relevant types of incidents and improving the sharing of lessons learnt from them.
• Continuing to develop and improve the reporting of outbreaks and incident management and the collation of the key lessons learnt from them.
• Developing standards to audit organisations’ performance in managing outbreaks and incidents.
• Developing on-going training for frontline staff in recognising and dealing with incidents.

Could consultees indicate any other areas for health protection services, which they consider to be deficient and require strengthening and give the reasons why.

The contribution of microbiology services to health protection?

Do consultees agree that:

• no change should be made to the organisational arrangements for non-reference microbiology services in Scotland?
• national standards should be adopted for all NHS laboratories, based on standard operating procedures developed in England and Wales?

It would be helpful to have views on:

• whether the current network of microbiology reference laboratories should be extended to deal with other micro-organisms and; if so, which;
• if their remit should be extended to test isolates from non-human samples;
• the scope for centralising all or the majority of reference laboratories in one NHS Trust or other appropriate service unit;
• whether you see a role in Scotland for the Inspector of Microbiology, expected to be appointed in England and what that role might be;
• the arguments for and against having the same standard operating procedures throughout the UK.

Options for Organisational Arrangements for Health Protection in Scotland?

Taking into account the considerations, criteria and options set out in Chapter 6, it would be helpful to have views on:

• which option is preferred and for what reasons?
• any downsides to the option you prefer?
• any other option, which would meet the criteria listed
• whether the role of the Advisory Group on Infection should be enhanced to provide an overview of health protection arrangements in Scotland? Are there any other functions the Group might discharge?

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