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Centre for Health Protection: Strengthening Health Protection in Hong Kong

The Centre for Health Protection (CHP) aims to enhance health protection measures in Hong Kong through science, surveillance, emergency response, legislation, programme development, international collaboration, research support, and expertise development.

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Centre for Health Protection: Strengthening Health Protection in Hong Kong

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  1. Background • In May 2003, the Chief Executive announced that the Government had begun to study the establishment of a CDC – like organisation in Hong Kong • SARS Expert Committee’s Report released in Oct 2003 recommended the establishment of a Centre for Health Protection (CHP)

  2. Health Protection • Health protection is about the measures that public health authorities and others take to protect the population from communicable diseases and other public health hazards • (Report of the SARS Expert Committee2003 )

  3. What differences will CHP make?

  4. International and Mainland authorities Community DH Hospital Authority/ Private hospitals and practitioners Universities Existing Interface Gaps

  5. Science Legislation Surveillance Programme Development Risk Management Effective Health Protection System Source: Health Protection for the 21st Century, Health Canada

  6. Review of mandate Promotion of standards SCOPING Assessment of potential building blocks of health protection • SCIENCE • Support of a • network of • laboratories • Laboratory • enhancement • Science-based • practice • SURVEILLANCE • Strengthening of • epidemiology as the • core competency • Enhanced • surveillance • EMERGENCY RESPONSE • Multi-disciplinary • emergency response • Centralisation of field • epidemiology services • Strengthening of • risk communication • LEGISLATION • Review of legislation in • communicable disease • control • PROGRAMMME • DEVELOPMENT • Set up specialised • health protection • programmes • INTERNATIONAL COLLABORATION • Coordination in Pearl River Region • Networking with international partners • RESEARCH SUPPORT • Incorporation of applied • research • EXPERTISE DEVELOPMENT • Reorganisation of public health training • Strengthening of fieldepidemiology as the core business • for investigation, analysis and rapid response capability

  7. Organisation of CHP Director of Health Controller, CHP SURVEILLANCE & EPIDEMIOLOGY BRANCH INFECTION CONTROL BRANCH PUBLIC HEALTH LABORATORY SERVICES PUBLIC HEALTH SERVICES EMERGENCY RESPONSE AND INFORMATION BRANCH PROGRAMME MANAGEMENT & PROFESSIONAL DEVELOPMENT BRANCH

  8. New functional elements • Epidemiology Unit • CD Surveillance Unit • Emergency Response and Information Branch • Programme Management and Professional Development Branch • Infection Control Branch • Health Protection Programmes for targeted diseases Existing services to be incorporated • Regional Offices • Disease Prevention and Control Division • Central Health Education Unit • TB & Chest Service • Social Hygiene Service • Special Preventive Programme • Pathology Service

  9. Risk Communication • Standardisation of Infection • Control Practice • Population Based • Programmes • Health Education • Programmes • Epidemic Intelligence • Communicable Disease • Notification • Training • Attachment Programmes International & Mainland authorities Community CHP • Communicable Disease • Information System • Health Protection • Programmes for • targeted diseases • Infection Control • Multi-disciplinary • Emergency Response • Professional • Development • Multi-disciplinary • Emergency Response • Appointed Collaboration • Centres • Health Protection • Programmes for • targeted diseases Universities Hospital Authority / Private Hospitals & Practitioners

  10. Strengths of CHP Three Rs: • Real-time surveillance • Rapid intervention & resolution • Risk communication

  11. Functional Branches

  12. Surveillance & Epidemiology Branch FUNCTIONS • Use contemporary IT programmes and infrastructures to collect, collate, analyse and disseminate surveillance data on notifiable diseases and other communicable diseases • Establish a central communicable disease information system • Manage & respond to communicable disease outbreaks and develop control measures • Mastermind a surveillance system for GD-HK-Macao and focus on the situation of communicable diseases in PRDR FACILITIES • Epidemiology Unit and its Outbreak Teams • Data Management Centre • Communicable Disease Surveillance Unit

  13. Priority issues • Enhance comprehensiveness and sensitivity of disease surveillance • E-Notification platforms for physician reporting • Centralised notification system for receiving reports of institutional outbreaks • Emerging infections surveillance network • Expanded surveillance network: local and international

  14. Priority issues • Strengthen Epidemiology and surge capacities • Epidemiology as core public health training • Set up structured Epidemiology Training Programme for specialist development • Exchange programmes and training for dealing with emerging pathogens • Training for supporting professionals and public health partners

  15. Infection Control Branch FUNCTIONS • Develop, promulgate and evaluate best practices in infection control at health care and non-health care settings • Coordinate, facilitate and support training in infection control for all levels of health care workers • Support epidemiological investigation of nosocomial infections in hospital • Conduct surveillance on infection hazards in health care and non-health care setting • Set up epidemiology and infection control units in five major public hospitals FACILITIES • Simulation Room • Epidemiology and Infection Control Units

  16. Branch Head Senior Microbiologist Specialist in ID Senior Epidemiologist Advisory Office Technical Support Division Clinical Consultation & Investigation Division Surveillance & Research Division Training programmes Expert Committees

  17. CHP Infection Control Branch Advisory Office Expert Panel on Infection Control Training & technical support Recommendations Coordinating body Training programmes Infection control committee Infection control committee Infection control committee hospital-based Epidemiology and Iinfection Control Units Interface in Infection Control Practices

  18. TMH PWH PMH PMH QEH QMH Epidemiology and Infection Control Unit

  19. Emergency Response & Information Branch FUNCTIONS • Overall corporate planning • Co-ordinate emergency response on a community/territory-wide basis • Contingency planning • Overall risk communication strategy • Update information system needs • Facilitate the development of preventive strategy and cross-sector logistic support • Develop contingency plans and arrange drills FACILITIES • Emergency Response Centre

  20. Crisis Communication Lifecycle Precrisis Initial Maintenance Resolution Evaluation • Be prepared. • Foster alliance. • Develop consensus recommendations. • Test message. • Acknowledge the event with empathy. • Explain and inform the public in simplest forms, about the risks. • Establish agency/ spokes-person credibility. • Provide emergency courses if action (including how/ where to get more information). • Commit to stakeholders and public to continued communication. • Help public more accurately understand its own risks. • Provide background and encompassing information to those who need it. • Gain understanding and support for response and recovery plans. • Listen to stakeholder and audience feedback, and correct misinformation. • Explain emergency recommendations. • Empower risk/ benefit decision-making. • Improve appropriate public response in future similar emergencies through education. • Honestly examine problems and mishaps, and then reinforce what worked in the recovery and response efforts. • Persuade the public to support public policy and resource allocation to the problem. • Promote the activities and capabilities of the agency (corporate identity reinforced- internally, too) • Evaluate communication plan performance. • Document lessons learned. • Determine specific actions to improve crisis systems or the crisis plan. (Source: Crisis, Emergency & Risk Communication, CDC)

  21. Public Health Services FUNCTIONS • Support the control of communicable diseases in the community (TB, HIV, STI) • Contribute to the surveillance of communicable diseases in Hong Kong • Provide specialised clinical services • Provide communicable disease treatment services • Consist of TB and Chest Service, Social Hygiene Service and Special Preventive Programme FACILITIES • Specialist Clinics • Public Health Units

  22. Priority issues • To evaluate and improve the notification and reporting systems for STI, TB and HIV/AIDS • To explore the role of information technology on surveillance and intersectoral coordination in relation to the above diseases • To facilitate the training and interchange of expertise between the public health stream and the clinical stream

  23. Public Health Laboratory Services FUNCTIONS • Provide pathology service for communicable disease surveillance and control • Provide laboratory support for outbreak investigations • Develop infection control standards in laboratory settings • Train microbiologists and infection control professionals for laboratory services • Collaboration with laboratories in HA, AFCD, Govt Lab, local universities and overseas agencies FACILITIES • Public Health Laboratory Centre

  24. Priority issues • To introduce new laboratories to improve investigative capacity, including the laboratories for antimicrobial resistance surveillance, molecular virology, etc. • To develop and evaluate new test and optimize current tests for earlier laboratory confirmation of SARS CoV and shorten turn around time

  25. Priority issues • To strengthen the networking and coordination with local universities, HA and other health care institutions on laboratory research and support of communicable diseases control • To enhance training for medical, scientific and technical staff

  26. Programme Management & Professional Development Branch FUNCTIONS • Coordinate and organise training activities for medical and nursing professionals of CHP, HA and other institutions • Liaise with local and international institutions to arrange attachment and exchange programmes • Carry out and coordinate research, including research projects in collaboration with universities, HA and other government departments • Manage health protection programmes • Coordinate with various advisory committees • Undertake health promotion activities FACILITIES • Library, IT facilities • Training Office • Research Office

  27. Health Protection Programmes

  28. Health Protection Programmesfor targeted diseases/ health hazards Three Dimensions • Multidisciplinary approach and intersectoral participation • Prevention – intervention continuum • Sustainable development

  29. Advisory Committee Controller, CHP S & E ER & I PHLS PHS IC Expert members CHP Core Group for HP Programme A Programme lead CHP Scientific Committee for HP Programme B Programme lead Expert members Hospital X University P HP Programme organisation

  30. Implementation Milestones

  31. Dec 2003 – Jan 2004 • Consultations with stakeholders on the establishment of CHP

  32. Mid 2004 • To establish CHP under a transitional stage • Appointment of Controller, CHP • Establishment of the Surveillance & Epidemiology Branch & Infection Control Branch • Enhancement of Multi-disciplinary Emergency Response Mechanism • Endorsement of Manpower Enrichment / Redeployment Plan

  33. 2005 • All functional elements of CHP to operate smoothly, including • Implementation of CD information system (by phases) • Implementation of manpower plan • CHP IT platform in place (e.g. e-notification system, case notification system)

  34. Thank You

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