1. Addressing safety and security while delivering an effective microbiology service Brian I. Duerden & Sam Gillanders Inspector of Microbiology and Infection Control, Department of Health

2. Management Responsibilities Do the job! –Clinical diagnosis –Public health investigations Do it safely –Staff doing the work –Visitors, students, the public Keep pathogens secure –In the laboratory –In transit

3. Inspector of Microbiology Champion & promote high quality clinical & public health microbiology –all labs in NHS contribute to surveillance –promote standards & quality –identify gaps in specialist & reference micro. –achieve adherence to SOPs –protocols to reduce the risk of loss/misuse –compliance with security Links with devolved administrations and internationally

4. Who is responsible? Laboratory management –Building security –People – safety and security Staff, visitors, students, couriers, public –Pathogen security (bioterrorism risk) Senior appointment(s) –Safety –Security

5. Elements in safety & security Laboratory facilities –Buildings and access –Equipment –Methods and procedures Staff –Appointment (screening, selection) –Training; supervision Pathogens –Storage, transport, disposal

6. Legal framework Health & Safety at Work Act 1974 Anti-Terrorism, Crime and Security Act (ATCSA) 2001 Control of Substances Hazardous to Health Regulations 2002

7. Guidance and advice Home office –Security standards for laboratories 2003 (restricted but available on request) (restricted but available on request) –Personnel security measures for laboratories ACDPHSECPA

8. Security and safety Security –Control of dangerous substances –Specified pathogens (Schedule 5) –Prevent access to these substances by those who seek to use them for terrorist purposes Safety –Any pathogens that could affect staff/public –Hazard groups –Risk assessment

9. Buildings/laboratory security 3 Ds – Deter, Detect, Delay BUT do not compromise staff safety Secure doors, windows –Physically robust –Locked –Alarms/cameras Access –restrict to specified staff/official visitors –Electronic locks (keypads not ideal) –No public thoroughfare

10. Key areas Category 4 - Safety and security priority Safety –Category 3 laboratories Restricted staff access Registered with HSE Security –Schedule 5 pathogens List of staff with access Register any stocks held with Home Office

11. Transport Safety –Courier, public, receiving laboratory –Required packaging, labelling –Protection from leakage and deterioration –Report adverse incidents/failures 2005 changes –From hazard group to Categories A & B Security – avoid risk of theft –Tracking and traceability

12. Data security Patient confidentiality –Caldicot etc Prevent terrorist access –Hard copy and computer records Stocks held Methods of preparation

13. Staff security Register of all staff Specific list of all staff with access to ‘dangerous substances’ (Schedule 5) List of staff with access to Category 3 laboratories (HSE) HO requires address and contact details for all staff with Schedule 5 pathogen access Full records – accessible BUT confidential

14. Recruitment procedures Check identity, address etc Registration proof (not photocopy) Qualifications Employment history – verified Unspent convictions References checked

15. ….not just new employees!! Existing staff LocumsVisitorsStudents Non-laboratory staff with access

16. Personnel responsibilities Training –Records Supervision –Formal statement and ensure it happens CPD, training updates

17. Pathogen classification ACDP/COSHH –Hazard group (Category) 1 – 4 –Category 4 – all agree highest level for safety and security ATCSA –Schedule 5 organisms (Australia list) Transport –Categories A & B

18. Transport regulation 2005 UN classification –Category A (dangerous substances) Packaging, labelling, secure hand-over, tracking, recording –Category B Packaging M. tuberculosis, VTEC, Sh. dysenteriae type 1 –Cat. A but may be treated as Cat. B if for clinical and diagnostic purposes

19. Transport aim Keep the ‘may be transported as Cat B’ option –Produce specific guidance –Ensure packaging and tracking –Remain Cat. A pathogens Report adverse incidents/inappropriate consignment to HSE

20. Consolidation Single package of advice to incorporate –Home Office –HSE –ACDP –Transport –Examples/templates Support CPA assessments ……….we will try to help!!