Health protection

Health protection is the branch of public health concerned with policies and practice to improve the prevention and control of infectious diseases and other environmental threats to the health of the population.

The aim of the new arrangements in place in England since 1st April 2013 is for an integrated, streamlined health protection system that delivers effective protection for the population from health threats, based on:

  • a clear line of sight from the top of government to the frontline;
  • clear accountabilities;
  • collaboration and coordination at every level of the system; and
  • robust, locally sensitive arrangements for planning and response.

A concise summary of the new public health system for England is contained in the Department of Health (DH) document - The new public health system: summary.

The Secretary of State for Health has the overarching duty to protect the health of the population, a duty which will generally be discharged by Public Health England (PHE).

The Health Protection Directorate of PHE is described in DH Factsheet - Structure of Public Health England, Pages 7-8 

The PHE Health Protection Directorate is responsible for ensuring that there are effective arrangements in place nationally and locally for preparing, planning and responding to health protection concerns and emergencies, including the future impact of climate change. PHE provides specialist health protection, epidemiology and microbiology services across England.

The role of the local authority Director of Public Health (DPH) is set out in DH publication Directors of Public Health in Local Government - Roles, Responsibilities and Context. It states that the DPH ‘should be the person who elected members and senior officers look to for leadership, expertise and advice on a range of issues, from outbreaks of disease and emergency preparedness through to improving local people’s health and access to health services’.

How the system works locally

The DPH is responsible for the local authority’s contribution to health protection matters, including the local authority’s roles in planning for, and responding to incidents that present a threat to the public’s health.

PHE has a responsibility to deliver the specialist health protection response, including the response to incidents and outbreaks, through the PHE Centres which take on the functions of the former Health Protection Units.

These roles are complementary and both are needed to ensure an effective response.

In practice this means that there must be ongoing communication between the PHE Centre and DPH regarding emerging health protection issues to agree the nature of response required and who does what in any individual situation. The local health protection system therefore involves the delivery of specialist health protection functions by PHE, and local authorities providing local leadership for health. In practice, local authorities and PHE will work closely together as a single public health system.

This joint working with clarity of responsibilities between them is crucial for safe delivery of health protection. Practical guidance is provided in the publication Protecting the health of the local population: the new health protection duty of local authorities under the Local Authorities (Public Health Functions and Entry to Premises by Local Healthwatch Representatives) Regulations 2013. 

There is also additional guidance on planning for health emergencies.

▼ Health Protection Regulations 2010 

In March 2010 a set of new health protection regulations were made under the amended Public Health (Control of Disease) Act 1984 to continue the process of modernising health protection legislation in England. The regulations cover requirements for notification of disease caused by infection or contamination by substances including chemicals or radiation and allow for prompt investigation and response; they contain evidential requirements and safeguards for people who might be subject to a JP order under the amended Act and they provide updated local authority powers to protect public health.

They can be found on the OPSI website as follows:

Guidance on the regulations has been published by the Department of Health as follows:

To assist EHPs in applying the regulations the CIEH has developed an interactive toolkit. The purpose of the toolkit is not to duplicate the Government guidance, but to provide a ‘grab and go’ suite of documents that can be used by authorised officers to deal with practical situations when they arise.

The Department of Health is currently analysing responses to a consultation on draft health protection regulations relating to ships and aircraft.

 
▼ Specific health protection guidance 

The CIEH has collaborated in the production of a variety of guidance which will be of assistance to its members and others. These include the following:

Bovine tuberculosis: guidance on the management of public health consequences of tuberculosis in cattle and other animals (England)
September 2014

This updated guidance, produced in consultation with CIEH and others, provides guidance on the approach to be taken by local public health authorities in England when assessing the risk to people who have been in close contact with M. bovis-infected animals. Similar guidance is already in place in Wales and Northern Ireland. Scotland is officially TB free and therefore manages incidents on an individual case by case basis.

Communicable Disease Outbreak Management: Operational Guidance
August 2014

Published by Public Health England with contributions from CIEH, this document provides a framework for the management of outbreaks of communicable disease in England

Public Health Operational Guidelines for Typhoid and Paratyphoid (Enteric Fever)
February 2012

A joint policy from the Health Protection Agency and the Chartered Institute of Environmental Health.

These guidelines, produced by a multi-disciplinary working group, are designed to provide a systematic approach to the public health management of enteric fever, based on expert consensus and available evidence from other non-endemic countries.

Preventing or controlling ill health from animal contact at visitor attractions - Industry Code of Practice
June 2012

The purpose of this Code of Practice is to help ensure health and safety at visitor attractions by providing sensible, practical and proportionate guidance on preventing or controlling ill health. It provides guidance, including pictures and real-life case studies, of practical measures that premises can apply to help them comply with the law and keep visitors safe. It includes an endorsement by CIEH.

The UK Recovery Handbook for Biological Incidents (UKRHBI)
 

The CIEH is participating in a project (led by the former HPA) to create a UK Recovery Handbook for Biological Incidents which will provide a decision-making framework for recovery and remediation strategies, after an incident involving a biological agent. The Handbook is being developed as part of a three year project (2012 – 2015), as a guidance document to assist with recovery strategies following an outbreak.
Similar handbooks have been developed for chemical and radiation incidents.

UK Recovery Handbook for Chemical Incidents (2012)

UK Recovery Handbook for Radiation Incidents (2009)
 

 
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