How prepared are we to manage within the community

1
(No Transcript)
2
How prepared are we to manage within the
community?

• Pandemic Influenza
• and Scotland

RCPE SEMINAR June 2006
3
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
4
InfluenzaThe Public Health Agenda
Avian Influenza
Seasonal Influenza
Pandemic Influenza
5
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.

6
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
7
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
8
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
9
   Pandemic Influenza Preparedness Standards
for Overall Strategic, Healthcare and Health
Protection Services
10
Aims

• 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

11
The Areas of Enquiry - 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 publics 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

12
For each Standard

• 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

13
Scoring System

• 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

14
Caveats

• 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

15
Health Protection
Surveillance
Investigation
Risk Assessment
Coordination
Communication
Risk management
16
National Scores for Standard 2 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 publics health
17
Health Protection Preparedness
18
NHS Scotland Preparedness for Pandemic
Influenza Standard 2
19
NHS Scotland Preparedness for Pandemic
Influenza Standard 2
20
Primary Care
21
National scores for Standard
3 NHS Boards have structures and processes in
place to ensure preparedness for responding to
the direct and indirect health consequences of an
influenza pandemic
22
Preparedness for Pandemic Influenza Standard 2
23
Conclusions

• 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

24
Acknowledgements

• 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

25
(No Transcript)