Health Protection Service Public Health Agency, Northern Ireland Dr. Lorraine Doherty Assistant Director of Public Health (Health Protection) Lorraine.doherty@hscni.net

Public Health Agency Established 1 April 2009 Chief Executive, 3 executive Directors – Public Health, Nursing & Allied Professions, Operations Director of Public Health - 4 Assistant Directors - Health Protection R&D Service Development and Screening Health & Social Well Being Improvement

Health Protection “Public health activities intended to protect individuals, groups, and populations from infectious diseases, environmental hazards such as chemical contamination, and from radiation” Includes emergency planning and response

Health Protection in Northern Ireland Pre 1st April 2009 DHSSPS responsible for health protection policy 4 Health and Social Services Boards DPH in each board with responsibility for health protection activities Consultant in Communicable Disease Control (CCDC) led on communicable disease control External expert advice sought when required, e.g. from HPA, ChaPD Assisted by Specialist Registrars, Health Protection Nurses and Emergency Planning Officers 2 surveillance centres – CDSCNI (infectious diseases) and HISC (SSIs)

From 1 April 2009 DHSSPS responsible for health protection policy Regional Public Health Agency with 1 DPH Assistant DPH leads Regional Health Protection Service Includes staff from previous Health and Social Services Boards, CDSCNI and HISC – CCDCs, Specialist Registrars, Health Protection Nurses, Infection Control Nurses, Regional Epidemiologists, Surveillance Staff and Emergency Planning Officers MOU with HPA in place

Health Protection Service Front line role in protecting the NI population from infectious diseases and environmental hazards by: - Surveillance and monitoring of diseases. - Operational support and advice to a range of health professionals/other stakeholders. - Response to adverse health Protection incidents – outbreaks etc. - Education, Training, Research. The Health Protection Service has a lead, front line role in protecting the population of Northern Ireland from infectious and environmental hazards through a range of core functions including: surveillance and monitoring, operational support and advice, response to adverse health protection incidents, education and training, and research. The service makes a direct contribution to public health, scientific knowledge and emergency planning operational decisions and response at regional, national and international level. In addition the Health Protection Service supports the work of DHSSPS in Health Protection through advice on strategic direction and informing health protection policy.

Assistant Director of Public Health (Health Protection) Dr. Lorraine Doherty Consultants in Health Protection (8.2) Consultant Lead, Health Protection Surveillance Consultant Nurse: Health Protection SpRs, FY2 Doctors, EPIET Fellows, Doctors in training Senior ICN (1) Health Protection Nurses (5.8) Infection Control Nurses 2.5 Emergency Planners (2) Health Protection Officer (1) HP Surveillance Staff

Health Protection Teams & Leads Acute Response/Duty Room Blood Borne Viruses/STIs Emergency Planning, Environmental Hazards, Environmental Health Gastrointestinal, Waterborne, Zoonoses HCAI, AMR, Infection Control Immunisation Respiratory Infections Training, Standards and Development Health Protection Improvement and Inequalities Health Protection Surveillance

Acute Response / Duty Room Consultant Nurse Officer (Duty Room) Health Protection Administrator Duty Room Duty Consultant Nurse

Health Protection- Acute Response Service First point of call in hours: PHA Duty Room Tel. 02890 553 994 Email – pha.dutyroom@hscni.net Deal with all incidents, immunisation issues, outbreaks, meningo cases, chemical incidents etc. HP Zone installed Out of hours - rota, accessed via NIAS control

Regional Duty Room Deals with all Health Protection queries, incidents Incident response HP Zone -installed & fully functional SOPS in place Community Associated C difficile cases surveillance established.

Health Protection Service Surveillance Team Consultant Lead for Health Protection Surveillance Epidemiological Scientist Band 7 Respiratory Infections / Zoonoses / Gastro Information Manager Band 7 Immunisation / VPs / STIs / BBVs / IT Epidemiological Scientist Band 7 HCAI / AMR Information Manager SSI Flu Surveillance Information Officer Band 5 Surveillance Information Officer Surveillance Information Assistant Band 4 Band 6 AMR / HIV / STIs Epidemiological Scientist Band 6 PVL / MRSA / CJD / CDiff Regional Surveillance Co-Ordinator Band 6 SSI Band 3

Surveillance Surveillance Forum AD Health Protection Dr Doherty (Interim Chair) Band 7 Surveillance Staff Health Protection Team Leads Surveillance Lead

Blood Borne Viruses and STIs Consultant in Health Protection (Team Lead) Consultant in Health Protection Health Protection Nurse Information Officer Information Manager Surveillance Support

Emergency Planning, Environmental Hazards, Environmental Health Consultant in Health Protection (Team Lead) Emergency Planning Officer Consultant in Health Protection (Emergency Preparedness)

Gastrointestinal, Waterborne, Zoonoses Consultant in Health Protection (Team Lead) Zoonoses GI Disease Waterborne Disease and IHR Disease Consultant In Port Health Information Officer Surveillance Support

HCAI, AMR, Infection Control Team Consultant in Health Protection (Team Lead) Senior Infection Control Nurse Infection Control Nurse Microbiology Consultant 2 Sessions 4 Sessions Information Manager Epidemiological Scientist Information Officer Surveillance Support

Immunisation Team Surveillance Support Consultant Nurse Consultant in Health Protection (Team Lead) Consultant Nurse Surveillance Support Information Officer

Respiratory Infections Team Consultant in Health Protection (Team Lead) Epidemiological Scientist Surveillance Officer Protection TB Protection Flu

Health Protection Nursing Consultant Nurse Senior Infection Control Nurse Control Health Protection

Training, Standards and Professional Development Team Consultant in Health Protection (Team Lead) Health Protection Nurse FY2 Doctor Training Lead SpR Training Lead CPD Lead Emergency Planning Audit & R&D

Health Protection Improvement and Inequalities Team Dr Lorraine Doherty (Team Lead) HCAI Lead TB and Migrant Health Lead Immunisation Lead Consultant Nurse HIV/STI Lead Port Health Lead

Our Stakeholders Public Health Agency Directorates, AMT etc DHSSPS – CMO’s Office, Primary Care, Minister Trust staff, Primary care Close links with COE, QUB Links to HPA (England), HPS (Scotland), PH W (Wales), HSE (Ireland), ECDC, CDC (USA). MOU with HPA for specialist support

Regional Health Protection Forum Advisory to Health Protection Service. Representation from across Health and Social Care System. Informs Business Plan and response plans. Forum for discussion Health Protection Challenges

Strategy and Planning DHSSPS Policy and Ministerial Targets PHA Corporate Strategy Public Health Directorate Plan Health Protection Service Business Plan

Excerpts from Health Protection Service Business Plan 2010/11

Work Programme 2010/11 Health Protection Duty Room Operational – SOPs, NOIDs, trained staff, HP Zone. Identify and respond to all health protection incidents. Ensure Surveillance of communicable diseases. Contribute to Review of PHA response to Pandemic Influenza, update and test plans.

Immunisation Lead Implementation of DHSSPS policy on Immunity Testing and MMR Immunisation for health care workers in Trusts. Increase HPV immunisation uptake rates Improve MMR uptake in hard to reach groups Respond to measles cases Achieve target for seasonal flu vaccine uptake rates Influenza Immunisation for Pregnant Women

HCAI Implement recommendations in DHSSPS HCAI Strategy - ‘Changing the Culture II’ for which PHA accountable. Lead Joint HSCB / PHA HCAI team and deliver on work plan. Provide HCAI improvement support to Trusts during 2010/11. Develop a HCAI action plan for Primary Care/Community.

Emergency Planning, Env Hazards and Env Health Ensure a joint PHA/HSCB/BSO emergency response plan is in place and tested. Standard Operating Procedures for the duty room and HP Zone; ensure implementation and usage of HP Zone by trained staff. Identify and respond to all emergency hazard notifications /incidents. Develop training programme for key staff

Transmit Primarily for HSC and Environmental Health professionals Monthly Bulletin Health Protection Service Primarily for HSC and Environmental Health professionals Objectives: To highlight local health protection issues To describe NI epidemiology trends and compare with GB/ROI Opportunity for non consultant staff to publish reports/studies

Summary Northern Ireland one unified Regional Health Protection Service Integrates Surveillance functions and Operational Health Protection elements = a strength http://www.publichealth.hscni.net/directorate-public-health/health-protection