health protection response to pandemic influenza in scotland
DESCRIPTION
Health Protection Response to Pandemic Influenza in Scotland. Dr Martin Donaghy, Health Protection Scotland, 15 th September 2010. Contents. Introduction Overview of Pandemic Timeline Pandemic management Pandemic Recommendations Policy Functions Processes. - PowerPoint PPT PresentationTRANSCRIPT
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Health Protection Response to Pandemic Influenza in Scotland
Dr Martin Donaghy, Health Protection Scotland,
15th September 2010
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Contents
• Introduction
• Overview of Pandemic
» Timeline
» Pandemic management
• Pandemic Recommendations
» Policy
» Functions
» Processes
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Investigation
Surveillance Surveillance &&
AssessmentAssessment
Control
Communication
Health ProtectionFunctions
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Incident Response
On-going management
Priority programmes
Major Incident Response
Pandemic Response
Incident Response
On-going management
Priority programmes
Major Incident Response
Pandemic Response
Health Protection Health Protection ResponseResponse
Increasing RiskIncreasing Risk
ContingencyContingency
Surge CapacitySurge Capacity
Command and ControlCommand and Control
ResilienceResilience
RehabilitationRehabilitation
Increasing ResponseIncreasing Response
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Scottish Government Health Directorate Policy & Performance Management
OperationalOperational
NHS BoardsNHS Boards
Pandemic Response Structures
UK Ministers/Officials
SAGE
JCVISPI-M
PICO
Scottish GovernmentHealth Protection, Healthcare, Civil
Contingencies, Public Communications
HPSNSS Divisions
Immunisation Steering Group
HPATacticalTactical
StrategicStrategic
SFREC
NHS 24NHS 24
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ProcessesPreparedness
• Generic Planning• Health Protection Framework• Exercises• Quality assurance
Containment Phase• Response co-ordination (Policy, UK implementation, Scottish Boards)• Surveillance and investigation• Guidance and expert advice • Immunisation Planning• Communications (internal, service and public)• Information Management
Treatment Phase; Influenza Response Co-ordinating Team• Intelligence and Surveillance• Guidance and expert advice • Immunisation Programme Management• Communications (internal, service and public)• Information Management and Technology
Lessons learned.
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•Laboratory testing of those suspected of having contracted H1N1• antiviral treatment of cases meeting the agreed case definition
• contact tracing, and prophylaxis of close contacts• closure of schools based on expert advice
• self-isolation of cases in the community• detailed investigation of cases and contacts
Containment: Reduce rate of transmission & gather evidence
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Containment Phase
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Containment Phase
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Treatment phase: mitigate impact
• Cases would be identified through clinical diagnosis, not swabbing• Contact tracing would cease
• Cases would be offered antivirals on the clinical discretion of GPs•• Vaccination would be offered to those most at risk
• Increasing the coverage of surveillance by involving all GPs•• Ensuring preparedness of hospital services.
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Treatment phase
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Treatment phase
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Policy
• Precautionary approach: international comparisons, triggers
• Flexibility: UK vs devolved
• De-escalation of response
• Scientific advice: openness, structures, understanding
• Prioritisation of public health activities
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Functions
Surveillance • National and local needs• UK Harmonisation• Burden of disease: mortality, severe
morbidity• Review shape of surveillance
Investigation• Field epidemiology• Serological studies• Molecular testing• Socio-economic gradient
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Functions
Risk Assessment • International collaboration• Modelling• Scottish dimension
Control• Immunisation: mass vaccination, effectiveness• Case & contact management: clinical input,
effectiveness, • Social mixing: PH legislation powers• Port health: UK collaboration• Infection Control: respiratory precautions
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Functions
Communications• Importance of web• Co-ordination of service and
public communications
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ProcessesGovernance
• Formal Framework: Boards, HPS, Scottish Government• Flexibility; national vs local• Performance monitoring• Intellectual property• Ethical Framework
Response Co-ordination • National framework• Common management structures• Primary care input, • National support: call centres, teleconferences• Labs, public health capacity
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Processes
Preparedness•Primary care input•Incident Guidance frameworks•National and local surveillance
Good Practice • Rapid production of Guidance• Clinical Input• Evidence base in uncertainties
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Processes
Information• Immunisation: Lifelong record• Health protection; SHPIMS• Primary care: consultation data• Capacity• Data management
Workforce Development• Capacity and resilience• Epidemiology• Leadership
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Conclusion
• Overall management of the pandemic response went well
• Many lessons learnt now being reported
• Need for targeting and prioritising of recommendations
• Experience of great relevance to Health Protection Stocktake