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How prepared are we to manage within the community?. Pandemic Influenza and Scotland. RCPE SEMINAR June 2006. What is being prepared to respond Preparedness Standards for Overall Strategic, Healthcare and Health Protection Services Conclusions on levels of preparedness in the community.

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How prepared are we to manage within the community

How prepared are we to manage within the community?

Pandemic Influenza

and Scotland

RCPE SEMINAR

June 2006


Content

What is being prepared to respond

Preparedness Standards for Overall Strategic, Healthcare and Health Protection Services

Conclusions on levels of preparedness in the community

Content


Influenza the public health agenda
InfluenzaThe Public Health Agenda

Avian

Influenza

Seasonal

Influenza

Pandemic

Influenza


Reasonable Worst Case Scenario

Single wave profile showing proportion of new clinical cases, consultations, hospitalisations or deaths by week.

  • Cumulative clinical attack rate up to 50% of the population over one or more waves of around 15 weeks each, weeks or months apart.

  • ‘Worst case’ of single wave.

  • Complication rate of up to 25%

  • Overall case fatality rate of up to 2.5%.

  • Hospitalisation rate of up to 4%.


Pandemic InfluenzaPlanned Response

End of first pandemic wave

Recovery

Alert Level 4

widespread activity

Maintain essential services

6-8

Weeks

Intense pressure

12 -15

weeks

  • Alert Level 3

  • outbreaks in UK

  • Adapt services

7-9

weeks

2- 4

weeks

Alert Level 2 new virus in UK Slow spread

Alert Level 1 no virus in UK

2- 4

weeks


Pandemic influenza preparedness in the eu

Integrated planning across governments.

Making plans operational at the local level.

Making sure that national plans and actions work well together between counties and within countries

Stepping up prevention efforts against seasonal influenza

Extending influenza research from basic science to include more operational research

Pandemic Influenza Preparedness in the EU


What needs to be done in the community
What needs to be done in the community

Limit transmission and mitigate impact

Keep society going

Civil Contingency

Public Health

Strategic Co-ordinating Groups

Health Protection

Care and treat sick and support their families

Health and Social Care

Primary Care, Community Care


Pandemic Influenza Preparedness Standards for Overall Strategic, Healthcare and Health Protection Services


Aims Strategic, Healthcare and Health Protection Services

  • To develop & pilot methodology in Standard

  • setting, monitoring and reporting for:

  • Health Protection

  • Health Care services

  • To develop & apply the standards to assess

  • Boards’ preparedness

  • To recommend future standard operating QA

  • process for Health Protection services

  • To give Boards a self-assessment tool for

  • future planning


The areas of enquiry the standards
The Areas of Enquiry Strategic, Healthcare and Health Protection Services- the ‘Standards’

Standard 1

Strategic: Structures and processes in place to ensure preparedness for managing the local NHS response to a pandemic of influenza

Standard 2

Health protection services: Structures and processes in place to ensure preparedness for limiting the transmission of pandemic influenza and its impact on the public’s health.

Standard 3

Healthcare services: Structures and processes in place to ensure preparedness for responding to the direct and indirect health consequences of an influenza pandemic

Acute Care

Primary Care

Pharmacy

Microbiology


For each standard
For each Standard: Strategic, Healthcare and Health Protection Services

  • Expansion into criteria and lines of enquiry

    i.e. specific questions

  • Boards self-assess according to standard QIS scores in the key areas of:

    Accountability

    Processes

    Audit & Review

  • Consensus scoring workshops (Jan & Mar 2007)

    Individual Board & National Scores

    Evidence


Scoring system
Scoring System Strategic, Healthcare and Health Protection Services

Score Definition

1 Board is still considering how to take forward their responsibilities

2 Board is actively developing the means to take forward their responsibilities

3 Board is actively implementing the means of meeting its responsibilities

4 Board is monitoring the adequacy of how they have implemented its responsibilities


Caveats Strategic, Healthcare and Health Protection Services

  • These are findings from pilot

  • The process is intrinsically subjective

  • Methodology assessment & validation

  • A measure of how well Boards are doing what they are expected to rather than how well they will respond to a pandemic


Health protection

Surveillance Strategic, Healthcare and Health Protection Services

Health Protection

Investigation

Risk

Assessment

Coordination

Communication

Risk management


  • National Scores for Standard 2: Strategic, Healthcare and Health Protection Services

    • NHS Boards’ health protection services have structures and processes in place to ensure preparedness for limiting the transmission of pandemic influenza and its impact on the public’s health


Health protection preparedness
Health Protection Strategic, Healthcare and Health Protection ServicesPreparedness


Nhs scotland preparedness for pandemic influenza s tandard 2
NHS Scotland Strategic, Healthcare and Health Protection Services Preparedness for Pandemic InfluenzaStandard 2


NHS Scotland Strategic, Healthcare and Health Protection Services Preparedness for Pandemic InfluenzaStandard 2


Primary care
Primary Care Strategic, Healthcare and Health Protection Services


National scores for Standard 3: Strategic, Healthcare and Health Protection Services

NHS Boards have structures and processes in place to ensure preparedness for responding to the direct and indirect health consequences of an influenza pandemic


Preparedness for pandemic influenza s tandard 2
Preparedness for Strategic, Healthcare and Health Protection ServicesPandemic InfluenzaStandard 2


Conclusions Strategic, Healthcare and Health Protection Services

  • NHS Scotland has made considerable progress in the last 2 years (since the Oct. 2005 National Contingency Plan) in being prepared to manage the community aspects of pandemic influenza

  • Progress has been greater in overall strategic decision-making and health protection & acute adult services than in primary care services

  • Emphasis should now be placed on developing health protection policy, primary care and tactical & operational planning

  • Integration with “routine” surge capacity and business continuity arrangements should be explored


Acknowledgements Strategic, Healthcare and Health Protection Services

  • Darren Ross, Ann Smith, Dr Jim McMenamin, Samantha Fleming, HPS

  • Jacqueline Campbell, Anne Aitken, Colin Robertson, Scottish Executive

  • Jim Miller, Lanarkshire NHS Board

  • Pandemic Flu QA Steering Group


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