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Health Protection Response to Pandemic Influenza in Scotland

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.

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Health Protection Response to Pandemic Influenza in Scotland

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  1. Health Protection Response to Pandemic Influenza in Scotland Dr Martin Donaghy, Health Protection Scotland, 15th September 2010

  2. Contents • Introduction • Overview of Pandemic • Timeline • Pandemic management • Pandemic Recommendations • Policy • Functions • Processes

  3. Health ProtectionFunctions Surveillance & Investigation Communication Assessment Control

  4. Scottish Government Health Directorate Policy & Performance Management UK Ministers/Officials PICO Pandemic Response Structures Strategic SAGE Scottish Government Health Protection, Healthcare, Civil Contingencies, Public Communications SPI-M JCVI Immunisation Steering Group HPA HPS NSS Divisions Tactical NHS 24 NHS Boards Operational SFREC

  5. Processes Preparedness • 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 .

  6. Containment: Reduce rate of transmission & gather evidence 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

  7. Containment Phase

  8. Containment Phase

  9. 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.

  10. Treatment phase

  11. Treatment phase

  12. Policy • Precautionary approach: international comparisons, triggers • Flexibility: UK vs devolved • De-escalation of response • Scientific advice: openness, structures, understanding • Prioritisation of public health activities

  13. 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

  14. 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

  15. Functions Communications • Importance of web • Co-ordination of service and public communications

  16. Processes Governance • 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

  17. Processes Preparedness • Primary care input • Incident Guidance frameworks • National and local surveillance Good Practice • Rapid production of Guidance • Clinical Input • Evidence base in uncertainties

  18. Processes Information • Immunisation: Lifelong record • Health protection; SHPIMS • Primary care: consultation data • Capacity • Data management Workforce Development • Capacity and resilience • Epidemiology • Leadership

  19. 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

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