UKHSA South West Health Protection Training Policy for Specialty Registrars in Public Health 

(and Arrangements for Participating in a Supervised On-call UKHSA Health Protection Rota) 

Contents

Document development group.................................................. 2

Contents.................................................................................. 4

PART 1..................................................................................... 7

UKHSA South West Region Health Protection Training – General Information.............................................................................. 7

1.0 Introduction.................................................................... 7

2.0 Scope of policy................................................................ 7

3.0 Placement locations in the South West............................. 9

4.0 Arranging phase 1 mandatory health protection placement............................................................................................ 9

5.0 Arranging extended health protection training placements.......................................................................................... 10

6.0 Induction...................................................................... 10

7.0 Outline of responsibilities and expectations.................... 11

PART 2................................................................................... 14

Phase 1 Health Protection Mandatory Placement – Detailed Outline.................................................................................. 14

8.0 Aims and objectives of mandatory phase 1 placement and supervised on- call.............................................................. 14

9.0 Meeting learning outcomes........................................... 16

10.0  Working in the Acute Response Centre (ARC)............... 16

11.0  Partnership and proactive health protection work........ 19

12.0  Project work............................................................... 19

13.0  Documenting learning experiences.............................. 19

14.0  Mid-Placement Review................................................ 19

15.0 Assessment of competence to participate in the UKHSA South West Region out of hours on-call rota......................... 21

16.0 Continued development of health protection competence post- placement.................................................................. 23

17.0 Arrangements for registrars undertaking supervised out of hours on-call....................................................................... 24

18.0  Placement evaluation and quality assurance................. 26

APPENDIX 1 Guidance for methods of assessment for core health protection competences......................................................... 26

APPENDIX 2: Assessment pro-forma for supervised on-call........ 28

APPENDIX 3 – Examples of formative assessment scenarios...... 31

APPENDIX 4 Supervision Pro-forma.......................................... 32

APPENDIX 5 – A ‘knows-how’ and ‘shows-how’ checklist to support Specialty Registrars in Public Health to develop a wider knowledge of the system of health protection (and show how this knowledge has ..........................................................................

been applied)......................................................................... 33

2.0 Know How Check list...................................................... 34

3.0 Show How Checklist....................................................... 36

4.0 Useful Supporting Reference Materials........................... 37

JESIP Website http://www.jesip.org.uk/home.............. 37

APPENDIX 6 - Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site........................................ 38

APPENDIX 7 – Pre-mandatory training placement meeting agenda/learning agreement.................................................... 42

 

JESIP Website http://www.jesip.org.uk/home

APPENDIX 6 - Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site

APPENDIX 7 – Pre-mandatory training placement meeting agenda/learning agreement

 

List of Figures

Figure 1      Public Health Training Pathway Outlining Health Protection Training

Opportunities

List of appendices

APPENDIX 1 - Guidance for methods of assessment for core health protection competences

APPENDIX 2 - Assessment pro-forma for supervised on-call 

APPENDIX 3 - Examples of assessment scenarios for supervised on-call 

APPENDIX 4 - Supervision pro-forma for Specialty Registrars on placement 

APPENDIX 5 - ‘Knows-how’ and ‘shows-how’ checklist to support Specialty Registrars in Public Health to develop a wider knowledge of the system of health protection

APPENDIX 6 -  Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site

APPENDIX 7 - Pre-mandatory placement meeting agenda/learning agreement

 

PART 1

UKHSA South West Region Health Protection Training – General Information 

1.0 Introduction

1.1 The Health Protection Team, in UKHSA has a strong commitment to training and will make every effort to ensure that public health specialty registrars have the widest opportunities to make the most of their placement, feel part of the team and gain good quality health protection training overseen by placement supervisor and the Deputy Director of Health Protection.

1.2 This policy document is in two parts. Part 1 outlines general information regarding health protection training offered to Specialty Registrars in Public Health attached to UKHSA South West Region. Part 2 outlines in further detail the phase 1 health protection placement delivered by UKHSA South West Region.

1.3 The policy is based on the 2022 Faculty of Public Health Specialty Training Curriculum, which replaced the previous 2015 curriculum in August 2022. 

1.4 Health protection is a fundamental tenet of public health delivery at local, national and international levels. Every educational /activity supervisor has a role to play in supporting registrars to understand and improve their knowledge of the health protection system and relevant opportunities for them to show this understanding throughout their training. Therefore, health protection training should start at the beginning of training at induction into the programme, through induction to Local Authority placements, formal teaching through the MPH/MSc as well as DFPH exam preparation

2.0   Scope of Policy

2.1 This policy applies to:

2.1.1 Registrars at the beginning of their training who will be introduced to the wider system of health protection including the roles and responsibilities of their host organisation. The checklist in APPENDIX 5 outlines additional ‘knows how’ and ‘shows how’ areas for the StR to work through from the beginning of their training and should be completed by the end of Phase 2. Evidence of working through the checklist will inform sign-off of health protection competency 6.9 towards the end of training upon entering ST5. 

2.1.2 The phase 1 health protection training rotation who must spend a minimum of four months whole time equivalent training for all registrars after taking the DFPH exam (Figure 1). This includes ongoing support and supervision following their placement to achieve all health protection competences including participation in the health protection out of hours on-call rota.

 2.1.3 Registrars in their final year of training who wish to develop further skills and knowledge in health protection can opt for an extended health protection pathway with UKHSA (Figure 1). Based on an assessment of learning needs, placements will be developed in partnership with several agencies which may include the UKHSA South West Region Health Protection Team, the Field Service based in Bristol, Local Authority Public Health Teams and specialist UKHSA divisions including the National Infections Service, Radiation, Chemicals and the Environment Directorate (RCE) or Emergency Preparedness, Resilience and Response (EPRR). These placements will be planned closely with the South West Public Health Training Programme Team to meet the training needs of the registrar.

2.2 This policy does not apply to placements outside of health protection provided by the UKHSA South West Region or Field Services during Phases 1 and 2 of training.

Figure One - Public Health Training Pathway and Health Protection Placements

PHASE

PHASE 1 (24 months)

Year of

training

 

ST1

ST2

Examinations

 

 

DFPH*

 

Knows

Knows how/Shows

Health Protection placements 

Developing knowledge of wider system of health protection through all phase 1 placements.

(See

Appendix 5).

4-month health protection placement and on-call assessment #

Assessment

of

programme

 

Assessment of progress will be through examination, workplace-based assessments, annual appraisal and annual review of competence progression (ARCP)

 

*Two sittings per year **Four/five sittings per year # Mandatory for all registrars

 

 

 

 

3.0   Placement locations in the South West

3.1 For their phase one 4-month full-time equivalent rotation, registrars will be placed in the South West Region Health Protection Team who operate as a team across Bristol and Totnes UKHSA offices and hybrid working (working from home). Registrars will be placed geographically according to their current training rotation as agreed with the South West Public Health Training Program Team. Registrars training in Devon, Cornwall and Somerset will be based at Totnes. Registrars training in Avon, Gloucestershire Wiltshire and Swindon will be based at Bristol. For registrars undertaking an extended  health  protection  placement  on  completion  of  phase  1  and  2 competences, placement location will be determined based on identified training need, but the substantive base will normally be one of the UKHSA South West Region bases (Totnes or Bristol).

4.0   Arranging phase 1 mandatory health protection placement

4.1 Registrars should start their health protection placement after successfully completing the DFPH exam. It is a curriculum requirement that the DFPH exam is passed prior to registrars commencing health protection on call. Additionally, due to time constraints, it is not recommended that registrars routinely sit exams during the placement.

4.2 The South West Public Health Training Programme Team are responsible for producing a timetable outlining health protection training placements. This is to coordinate the flow of registrars required to do the placement and because there are  limited placements within the health protection team. The list  is updated following DFPH exam results. The registrar should then contact the health protection UKHSA South West Region Specialty Tutor (Jonathan Roberts), to arrange a pre-placement meeting (no later than 4 weeks before the tabled commencement date.  The registrar will be assigned a UKHSA placement supervisor (accredited to train through the Training Programme Team) who will be responsible for the duration of the placement working alongside the registrar and their Educational Supervisor.

4.3 The pre-placement meeting between the health protection supervisor and registrar discuss previous health protection experience, identify learning needs and agree a provisional learning contract (See Appendix 7).  As well as a brief introduction to work undertaken in the Acute Response Centre,  the meeting will provide an opportunity to discuss a health protection project to  be completed whilst on placement.  The learning agreement should be agreed  between the registrar, the placement supervisor and the educational supervisor.

4.4 At the pre-placement meeting the registrar should make their health protection placement supervisor aware of  any special needs, e.g. disabilities, part-time work, or any annual leave or study leave they need to take during the placement. The duration of the placement may need to be extended to take account of this.

4.5 At the pre-placement meeting registrars will be provided with induction information and agree with their project/educational supervisor the relevant visits and key individuals/agencies they should meet during their placement. Registrars should commence planning for these visits prior to starting their placement.

4.6 Specialty Registrars in Public Health will have an honorary contract with UKHSA for the duration of their training. This is coordinated by the UKHSA admin team (swhpt@ukhsa.gov.uk) and will be set-up in advance of the placement commencing. Specialty Registrars in Public Health are DBS checked at the start of their training and records are held by the Training Programme Team.

5.0 Arranging extended health protection training placements

5.1 On completion of all phase 1 and  phase  2  competences,  registrars  may consider, with the Training Programme Team, an extended placement in health protection.

5.2 The placements will only be agreed for a minimum period of 6 calendar months. Following discussions with Training Programme Team, the registrar should arrange a meeting with the UKHSA Specialty Tutor for Health Protection at least 8 weeks prior to an anticipated placement start date. At this pre-placement meeting,  a  bespoke  training  programme  and  learning  agreement  will  be developed to address learning needs identified by the registrar.

5.3 Based on identified learning needs, activity supervisors may also be appointed to support the specialist placement from other specialist teams within UKHSA that support health protection delivery (e.g. Radiation, Chemicals and the Environment Directorate) and the Local Authority Public Health Teams.

5.4 Where there is a vacancy and in accordance with the South West Public Health Training Programme Team, registrars on an extended training placement may apply for an ‘Acting-Up’ post. Such posts will be discussed with the registrar during their placement. These posts are advertised to all registrars eligible for an ‘Acting-Up’ post and are not exclusive to those on the extended placement. 

6.0   Induction

6.1 The aim of induction is to enable registrars to become acquainted with the training location, UKHSA organisational structures including the South West Region, roles of team members and roles and responsibilities of external partners.

6.2 Registrars will have a structured induction overseen by their health protection placement supervisor using a UKHSA induction pack provided to them. Registrars with advice from their placement supervisor should familiarise themselves with local  reference materials, resources and local tutorials they can access during this time. 

7.0 Outline of responsibilities and expectations

7.1 UKHSA expect the following from registrars during all health protection placements

7.1.1 to  inform  their  health protection  placement  supervisor  of  any  special requirements, ideally at the pre-placement meeting;

7.1.2 to  agree  a  learning  contract  with  their  health  protection  placement supervisor and educational supervisor;

7.1.3 to attend the work place as required and on time;

7.1.4 to share their outlook/work diaries with UKHSA staff;

7.1.5 to notify their health protection placement supervisor (or unit administrator if not available) when ill and unable to work;

7.1.6 to act in accordance with the UKHSA values, policies and procedures, including health and safety;

7.1.7 to agree  tasks  and  projects  with  their  health  protection  placement supervisor;

7.1.8 to participate in one-to-one supervision sessions  with  their  health protection placement supervisor;

7.1.9 to attend  weekly clinical  meetings  and  other  meetings  to  maximise learning as advised by the health protection placement supervisor;

7.1.10 to work closely and collaboratively with all members of the UKHSA team;

7.1.11 to inform their health protection placement supervisor of non-health protection pieces of work to be completed during the placement;

7.1.12 to alert their health protection placement supervisor if deadlines on health protection work are at risk of not being met;

7.1.13 to hand-over cases and significant events at work in a timely manner;

7.1.14 to maintain high quality records in accordance with UKHSA policies (please refer to APPENDIX 6 for supplementary information);

7.1.15 to inform the health protection placement supervisor of any difficulties straight away, including concerns about lack of opportunities to gain experience;

7.1.16 to participate in local on-call training days and health protection training events;                                                                                                                              10

7.1.17 to reflect on learning experiences and document these in a log book;

7.1.18 to provide mutual support to other registrars attached to the team;

7.1.19 to work as engaged members of the health protection team and recognise the pressures on other team members and work collaboratively to balance personal needs and team need appropriately.

7.2 Registrars should expect the following from UKHSA during their health protection placements:

7.2.1 to support the registrar to identify learning needs;

7.2.2 to provide learning opportunities which contribute to meeting learning needs and competencies;

7.2.3 provision of formal and documented one-to-one supervision using the agreed supervision template (Appendix 5 – to be completed by registrar) on a frequency no less than fortnightly;

7.2.4 to agree the learning agreement with the registrar and educational supervisor;

7.2.5 to regularly monitor the registrar’s performance considering  feedback from other members of the team and relevant partners

7.2.6 to formatively assess the individual’s competence in health protection;

7.2.7 to formatively assess the individual’s competence to commence supervised on-call (see 14.4 and Appendix 3);

7.2.8 to sign and return Activity Summary Sheets and liaise with the registrar’s educational supervisor to agree Learning Outcomes, Summary of Assessment Sheet and Annual Review of Competence Progression (ARCP) forms as required and in a timely manner;

7.2.9 to liaise with the registrar’s educational supervisor as and when required.

7.3 UKHSA  will  provide  the  following  resources  for  registrars  on  health  protection placements:

7.3.1 access to desk-space, a laptop, telephone, the internet, email and IT support when working in the office; 

7.3.2 access to laptop and IT support, as required, when working from home and when on-call;

7.3.3 access to the UKHSA resources and signposting to other key national and regional resources;

7.3.4 administrative support may be available by negotiation for specific activities.

7.4 With regards to leave of absence:

7.4.1 annual leave, study leave, and other planned leave should be negotiated with the health protection placement supervisor in conjunction with the training programme team as appropriate;

7.4.2 registrars will be expected to report sickness absence in a timely way to SWHPT@ukhsa.gov.uk and copied to their health protection placement supervisor during their health protection placement, or when on-call, which should subsequently be reported to the Training Programme Team by the supervisor. 

 

PART 2

Phase 1 Health Protection Mandatory Placement – Detailed Outline

8.0 Aims and objectives of mandatory phase 1 placement and supervised on- call

8.1 The placement and supervised on-call experience are designed to ensure that registrars meet   core health      protection competencies considering         their background and existing knowledge and skills, with the aim of ensuring that they become familiar with the scope and practice of health protection.

8.2 The main aims are to:

8.2.1 ensure registrars successfully meet key area 6 competences outlined in the 2022 Faculty of Public Health training curriculum;

8.2.2 provide registrars with an understanding of health protection practice and the system of health protection from within which the UKHSA health protection team operates;

8.2.3 prepare registrars to take part in the UKHSA South West Region supervised health protection on-call rota;

8.2.4 enable registrars to further develop health protection skills following the placement through structured support and supervision.

8.3 The placement has the following objectives. At the  end  of  the  placement, registrars should have a general understanding of:

8.3.1 surveillance of communicable disease and environmental hazards;

8.3.2 roles of various agencies in diagnosis, prevention and control of communicable diseases and environmental hazards;

8.3.3 the legal basis of communicable disease control;

8.3.4 delivery of infection control in the community;

8.3.5 the role of immunisation including systems for monitoring vaccine uptake and adverse events and approaches to running immunisation programmes; 

8.3.6 the role of public health in emergency planning;

8.3.7 environmental epidemiology and health risk assessment.

8.4 At the end of the placement, registrars should have developed skills in:

8.4.1 investigation and follow up of single cases of common communicable diseases;

8.4.2 using HPZone (case and incident management system) for day to day health protection work;

8.4.3 investigation of outbreaks/incidents including the application of appropriate epidemiological methods and production of written reports;

8.4.4 advising professionals and the public on communicable diseases and potential health effects of environmental hazards;

8.4.5 identification and management of clusters;

8.4.6 communications and working with the media;

8.4.7 risk assessment and risk communication;

8.4.8 interpretation and presentation of data;

8.4.9 advising professionals and the public.

8.5 By the end of the placement, registrars should have increased their knowledge of:

8.5.1 major health protection issues/key policies and guidelines;

8.5.2 how to keep up to date with health protection issues;

8.5.3 sources of advice for health protection issues.

8.6 It is acknowledged that it may not always be possible to achieve all the above in the  initial four months full-time equivalent placement and registrars may need to extend or pursue  further short-term placements subject to Training Programme Team’s agreement. 

9.0   Meeting learning outcomes

9.1 Registrars will participate in the investigation and management of single cases of communicable diseases and outbreaks/incidents including chemical incidents, as well as attend relevant meetings. Registrars will also be expected to complete a short  health protection project during their placement which may contribute to meeting competes in other areas of the curriculum. This should be discussed and time allocated agreed with the placement supervisor. APPENDIX 1 outlines key area  6  learning outcomes and suitable assessment methods.

9.2 Where direct experience cannot be achieved in the four months (e.g. outbreak management) specific tutorials, exercises or discussion and opportunities for extra placement time will be arranged to address these needs. Registrars will be offered the opportunity to visit and learn from  key staff, such as Consultants in Health Protection, Health Protection Practitioners, Environmental Health Officers, epidemiologists, information staff and microbiologists.  This  will  be  identified through the learning agreement between the registrar and the health protection placement supervisor.

9.3 The formative assessment to confirm readiness for supervised on-call (Appendix 2 and 14.4) will be undertaken towards  the  end  of  the placement to contribute to the evidence for the faculty competences requiring sign-off before a registrar can join the on-call rota. 

10.0   Working in the Acute Response Centre (ARC)

10.1 The ARC is the central point for the UKHSA response to notifications of cases of infection, incidents and enquiries. Enquiries are received from other professionals and the public on a wide range of health protection issues.

10.2 The UKHSA South West Region provides an acute response service managed by a senior health protection practitioner and staffed by a team of practitioners, administrators and a duty consultant on a rota basis.  Registrars will be required to attend the office as per current UKHSA policy. 

10.3 Registrars will be briefed about local ARC arrangements. The average registrar would need to spend between 50% and 75% (dependent on previous experience) of their placement working in acute response to gain the required competence. An equivalent period will be worked out for registrars working less than WTE on a pro rata basis.

10.4 During this period the registrar will be expected to respond to cases, incidents and enquiries working with the duty team. Registrars will never be expected to work  unsupervised ,  and  appropriate  support  and  supervision  will  be  provided.

Registrars on their mandatory placement will always be considered as supernumerary capacity and not used to cover practitioners or consultants during their time in the ARC.

10.5 Registrars should recognise the limits of their competence and be prepared to ask for advice and assistance. Regardless of whether they are working from home or the office, the duty consultant will be accessible to support and supervise the registrar and advice can also be sought from the health protection practitioners. When working in the ARC, registrars will also be expected to take part in daily Sit-rep meetings and other clinical review meetings as advised by their health protection placement supervisor.

10.6 Registrars will be asked to review the in-hours ARC rota and self-select their ARC days. They will be encouraged to avoid days already taken by other visitors to the ARC.

10.7 Before working in the ARC registrars will have:

10.7.1 completed local induction and the national on-boarding process.  

10.7.2 have completed UKHSA’s mandatory training including fire safety, information governance and safeguarding and any other mandatory training topics that may be required (registrars will be informed of a list of modules at the beginning of their placement);

10.7.3 become adequately familiar with the health protection team and office environment;

10.7.4 received basic training on HPZone (case/situation management system);

10.8     When rostered to work in the ARC registrars will:

10.8.1 work under the supervision of the health protection ARC duty manager;

10.8.2 recognise and acknowledge limits to their competence;

10.8.3 offer to ring the caller back if unsure of the response and then discuss the response with a member of the duty team for the day or the duty Consultant;

10.8.4 follow UKHSA policy and standard operating procedures;

10.8.5 record information accurately and contemporaneously on HPZone.

10.9     After each day in the ARC registrars will:

 10.9.1 review daily the cases and enquiries completed with the duty consultant or other nominated duty professional as necessary;

10.9.2 ensure that any follow-up required is undertaken or passed on to appropriate colleagues or the duty consultant. This is particularly important if the registrar will not be available later or the following day;

10.9.3 record in their training log the details and key learning points of cases, enquiries and issues dealt with;

10.9.4 identify learning points and issues, which require further discussion on a one to one basis with the placement supervisor or at the weekly clinical team meeting.

10.10 To meet competences registrars will be expected to be involved in major incidents/outbreaks that may occur and invited to take part in incidents requiring mutual aid, or the response to incidents that would provide a good training opportunity.  

11.0   Partnership and proactive health protection work

11.1 Registrars will be offered the opportunity to attend scheduled meetings with local partners, together with a consultant in health protection or practitioner. The main aims of attendance for registrars are to develop an understanding of key issues, the role of the UKHSA in these contexts, the roles of a range of partners and how the UKHSA works with partners to strengthen the health protection system. This will build on experience gained by the registrar in their other phase 1 placements and their progress against the checklist outlined in APPENDIX 5.

11.2 Examples of meetings may include routine partnership meetings such as Local Authority Health Protection Committees, Local Infection  Control Committees, meetings with environmental health, local water companies and laboratories, port health, clinical strategy groups such as sexual health, blood- borne viruses; public health strategy groups such as immunisation and Emergency Planning such as Local Resilience Forum meetings.

11.3 Opportunities should be made with the placement supervisor to discuss these meetings, context and reflect on learning points.

12.0   Project work

12.1 Registrars will be expected to undertake a health protection project during their placement. The projects chosen will be negotiated between the registrar and their health protection placement supervisor (and where appropriate the educational supervisor of the registrar) and  should  address gaps  in competence. The health protection placement supervisor will oversee their project. The project undertaken may contribute to meeting competences outside of key area 6 in the 2022 curriculum.  

13.0   Documenting learning experiences

13.1 A health protection logbook and summary sheet (for reflections on at least 5 significant cases/enquiries/situations managed) should be completed omitting any personal identifiable information.

13.2 The log and summary sheet should be discussed at 1:1 supervision sessions. The registrar should submit documentation at least 48 hours before the meeting time.

14.0   Mid-Placement review

14.1 As well as regular 1:1 supervision, a formally documented mid-placement review will be scheduled to review placement progress. This will include the registrar’s Educational Supervisor. The mid-placement review will consider progress against competences outlined in the placement learning agreement. It will determine whether an extension might be required to ensure the registrar achieves sign-off for competence to join the out of hours rota. If an extension period is agreed, the project supervisor will notify the South West Public Health Training Programme Team as this might impact on the proposed start dates of other registrars.

14.2 Checkpoints for consideration at the mid-placement review in relation to acute response should include:

14.2.1 demonstrable awareness of the ARC systems and processes;

14.2.2 ability to confidently use HPZone for case and incident management;

14.2.3 demonstrable awareness of the available tools and guidance documents, including local SOPs;

14.2.4 familiarity with the issues and approach required to respond to urgent cases;

14.2.5 demonstrable evidence that registrar is working within their competency levels and  is happy to  consult colleagues as appropriate;

 14.2.6 all mandatory training completed in relation to information governance and takes consistently, clear and concise notes;

 14.2.7 awareness of and has commenced signing into the hunt group when on duty.

15.0   Assessment of competence to participate in the UKHSA South West Region out of hours on-call rota

15.1 Registrars seeking to start supervised out of hours on-call duties need to fulfil the following criteria before they can be assessed as competent for this role:

15.1.1 have passed DFPH of the Faculty of Public Health membership;

15.1.2 Registrars should usually commence out-of-hours supervised oncall once they have demonstrated learning outcomes 1.2, 4.2, 6.1 - 6.6, and 9.2 (the latter must be assessed in the health protection setting event if it has been signed off in another placement).

15.1.3 have successfully completed the formative assessment for supervised on-call (Appendix 2) as evidence to underpin required competences (see 14.1.2);

15.1.4 have maintained (and continue to maintain) a log-book documenting cases and incidents experienced and reflecting on the events as a learning experience regularly with their placement supervisor;

15.1.5 have  experienced  or  received  training  in  a  range  of  common scenarios (APPENDIX 3).

15.2 Formative Assessment will be against performance criteria identified in the Faculty of Public Health Specialty Training Curriculum 2022 using the assessment pro-forma Appendix 1.

15.3     Methods of formative assessment will include:

15.3.1 direct observation;

15.3.2 case based discussion through log-book;

15.3.3 review of case documentation;

15.3.4 feed-back on performance including multi-source feedback.

 15.4 The formative assessment for supervised on-call will be carried out by ahealth protection placement supervisor(s) and/or a senior health protection practitioner deemed by the Deputy Director of Health Protection as competent for this role and using the assessment pro-forma (Appendix 2).

15.5 The purpose of the formative assessment for supervised on-call is to assess that the trainee:

15.5.1 understands the professional responsibilities of being on-call;

15.5.2 understands the roles and responsibilities of key Out of Hours partners and organisations;

15.5.3 has adequate theoretical knowledge of communicable diseases and environmental hazards to support the management of out of hours cases / incidents and undertake a risk assessment;

15.5.4 knows where to find further resources and guidelines, and

15.5.5 can discuss  the  issue  with  the  consultant  on-call  outlining necessary public health action.

15.6     The trainee is not expected to manage the scenario at consultant level but to assist the consultant on-call in effectively gathering information, making a risk assessment and taking appropriate action required under the guidance of the consultant.

15.7 For the assessment for supervised on-call three health protection scenarios will be discussed. Examples of the cases/ incidents that will be used to inform scenarios are presented in Appendix 3. The candidate will be asked to outline their response for the ‘out of hours’ management of the 3 case/incident scenarios and be given 45 minutes on their own to prepare for this. After 45 minutes, the candidate will report each plan back to the assessors who may ask subsidiary questions to clarify information presented. The candidate will have access to HPZone, internet access and other support materials they would routinely be available to those on-call.

15.8 The outcome of this assessment will be provided by the assessors on the same day as the assessment. The pro-forma (Appendix 2) including feedback will be completed by the assessors and given to the registrar within three working days following assessment.

15.9 Should a registrar fail the assessment for supervised on-call, they will be supported to identify further learning needs over an agreed timeframe and arrangements will be made to re-assess with a different health protection placement supervisor and senior health protection practitioner.

15.10 Should they fail this second assessment, the health protection placement supervisor will meet with the registrar’s Educational Supervisor and specialty tutor to discuss this further and agree remedial action required where appropriate. This will be reported to the SW Public Health Training Programme Team for their agreement.

15.11 When the registrar has completed the requirements outlined in 14.1 and is ready to join the out of hours rota, the health protection placement supervisor must inform the South West Public Health Programme Team Training Programme Director in writing with a provisional start date. The health protection placement supervisor will ensure that registrars are not rostered for on-call duties until a start date has been agreed. If a registrar is required to cover a gap in the rota before the agreed start date, the South West Public Health Programme Team will be notified so on-call payment can start from that date.  

15.12  registrars should contact the rota co-ordinator so they can be added to distribution lists and allocated to the next available rota.  Registrars can be available to cover gaps in the current rota or cover sickness if required before the next full rota starts.  

16.0   Continued development of health protection competence post- placement

16.1 Registrars training in the South West should be assessed against LO 6.9 upon entering their ST5 year. It is the expectation that full sign off of LO 6.9 is completed at the start of the final year of training.  The KA10 panel would not expect LO 6.9 to be signed off prior to the review meeting (held 12 months wte prior to CCT) but the Registrar should have a plan and timeline agreed to sign off this outcome. 

16.2   To achieve competence 6.9 registrars will have to meet the following:

16.2.1 undertaken a minimum of approximately 40 on-call sessions as first responder and demonstrate a breadth of out of hours health protection activity and appropriate response through their logbook. A 24- hour weekend shift counts as 2 sessions (e.g. 9 am Saturday to 9am Sunday). This is a guide and breadth of activity and reflection of learning points supersedes quantity of on-call undertaken;

16.2.2 To further develop and maintain competence and meet learning needs at least 3 days per quarter / 1 day per month should be spent with the HPT/supervisor (but preferably in a block of 3 days);   If there are any concerns about the Registrar’s competence on-call the frequency or number of these ‘update days’ can be increased in agreement with the Training Programme.

16.2.3 demonstrated additional Continued Professional Development in health protection (e.g. attending on-call training days / relevant conferences / contributing to or appraising and reporting on relevant papers);

16.2.4 maintained a reflective log-book and met with the health protection trainer at least twice per annum to review this over the period they are on-call.

16.2.5 Demonstrated a wider understanding of the health protection system with reference to how they have used the supplementary knows how and shows how check list whilst engaged in phase 1 and phase 2 placements (Appendix 5). 

17.0   Arrangements for registrars undertaking supervised out of hours on-call

17.0 Specialty Registrars in Public Health who have completed their Health Protection rotation and assessed as competent (as per 14.1) will be invited to join the rota to be the first point of contact alongside the health protection practitioner team. 1.0wte Specialty Registrars will be expected to complete 10 sessions of on-call every three months. Registrars should aim for the majority of the on-call allocation to be Saturday, Sunday or Bank Holidays as these are the days when they are most likely to handle calls to support learning. The remaining t im e will be allocated to week nights. One 24-hour period of on-call will count as two on- call sessions (e.g. 9am Saturday until 9am Sunday). For those working less than 1.0wte, the allocation will be proportionate to hours worked.  The training programme recommends that Registrars undertake at least one episode of bank holiday on-call work in their cycle of training.  Being on-call on a bank holiday gives a different experience and we encourage Registrars to do this as part of their training and learning experience. 

17.1 At these times, registrars on the rota will be the first point of contact for one of the three on-call geographies:

17.1.1 Devon and Cornwall;

17.1.2 Somerset and Dorset

17.1.3 Avon Gloucestershire and Wiltshire.

17.2 As the UKHSA South West Region delivers one acute response service for the South West, a registrar may be required to support any one of these geographies whilst on-call regardless of their site of training.

17.3 UKHSA will provide a mobile phone for the duration they are on the on-call rota. These are available through the Regions’ Business Management Team / Placement Supervisor.

17.4 Registrars will need to complete approximately 40 on-call sessions and demonstrate through their log-book a good breadth of health protection activity and response for competency 6.9 to be signed off, with the expectation that this will occur towards the end of training upon entering ST5 (see 15.1).

17.5 Although the registrar will cover a geographic area of the South West when on-call, they are part of an on-call team and support will be available from the practitioners on the same on-call tier or the on-call consultant at any time.

17.6 Feedback and discussion of any learning points observed for activity undertaken by the registrar should be provided at the earliest opportunity (preferably within 24 hours of the shift).

17.7 Registrars will be expected to record, and report on-call activity undertaken to the health protection practitioner they are on-call with to support handovers.

17.8 Where registrars have been involved in cases/situations over their on-call shift, they will be expected where possible to dial-in to the 9.30am health protection team Sit- Rep on the next working day to handover.

17.9 Registrars are responsible for checking their IT and access to HPZone prior to commencing an on-call shift and flag any issues with the health protection admin team and on-call duty consultant to resolve issues with sufficient time. 

17.10 Registrars on-call will be remunerated as per current arrangements with the South West Public Health Training Programme Team. Once the registrar has achieved their health protection learning outcomes including 6.9, they will no longer be required to undertake health protection on-call. Should they wish to remain on the on-call rota for professional / continued development purposes, this will need to be agreed by the health protection Specialty Tutor and South West Public Health Training Programme Director.

17.11 The following rules as outlined by the South West Public Health Training Programme Team following Doctors in Training hours of work in the NHS Terms and Conditions apply to registrars participating in the out of hours on-call rota:

17.11.1 The maximum length of an individual on-call duty period is 24 hours, and if a Registrar is working in their normal place of work the day after an on-call this duty period must not exceed 32 hours during weekdays and 56 hours following a weekend.

17.11.2 On-call periods are permitted to be worked consecutively in weekdays but only if the intensity of the on-calls is not high and sufficient rest is being achieved.  It is permitted for two consecutive weekend days to be worked.  There must be no more than three on-call periods in any period of 7 consecutive days.  

17.11.3 registrars will not be required to work more frequently than a 1:9 rota;

17.11.4 activity must be consistent with registrars working within their contracted hours;

17.11.5 in the case of a less than full time registrar their contribution must be proportionate to their hours of work i.e. if working 0.6wte they must have on-call duties equivalent to 60% of whole-time registrars;

17.11.6 registrars should also achieve a minimum of 5 hours continuous rest during the hours of 10pm and 7 am.

17.12 If Registrars are breaching these rules they must complete an exception Reporting form and discuss this with their Health Protection supervisor and the Deputy Director.

17.13 The Terms and Conditions for Registrars undertaking on-call shifts on bank holidays does mean that they are entitled to time off in lieu for those shifts.  For each bank holiday they are entitled to one day off as time off in lieu.  Educational supervisors will be required to approve the time off in lieu in liaison with the Health Protection supervisor for the Registrar in order to confirm that the on-call episode took place.   The Registrar should email their educational supervisor, health protection supervisor and copy in the training programme team to inform them that they have worked a bank holiday and they wish to take their time off in lieu at a given date and time.  The Health Protection supervisor should confirm that they did in fact work a bank holiday on-call shift and the educational supervisor should then give approval for the time off in lieu.

The Registrar will be required to record this on the leave Accent system.  The Registrar should add their TOIL date(s) onto the system in the same way they would apply for other leave but enter 0 into the days/hours box and then add a statement in the comments box that this is TOIL.  The Registrar should ensure that they keep the email record of approval from their educational supervisor as confirmation as they would for any other leave.

Similarly if an exception is reported and requires TOIL to be taken then the above process will be used for this also.

18.0   Placement evaluation and quality assurance

18.1 As part of the pre-meeting, the health protection placement supervisor will advise the registrar that they are the first point of contact for discussions about the placement itself and will provide opportunities throughout the placement to discuss concerns or ways to improve the placement experience. This will normally be considered during formal one to one supervision sessions (see Appendix 4) and will involve the Specialty Tutor if required.

18.2 At the end of the Phase 1 placement, the registrar will be asked to provide feedback on the placement as part of an exit meeting (although it is acknowledged that support and supervision will continue whilst the registrar is on the out of hours on-call rota and to achieve remaining competences (namely 6.9).

18.3 The Specialty Tutor will also contact the registrar to ensure all relevant feedback is captured to inform future placements.

18.4 The Deputy Director of Health Protection will formally meet with members of the South West Public Health Training Team and registrar representative(s) quarterly to review health protection placements and ensure that the health protection training policy is being upheld and updated as required.

18.5 All health protection placement supervisors will remain fully accredited. Failure to do so will result in their being removed from the list of UKHSA accredited supervisors until such time that gaps in accreditation are met.

18.6 There will be a named UKHSA South West Region Health Protection Specialty Tutor. This individual will participate in monthly Specialty Tutor meetings convened by the South West Public Health Training Programme Team.

18.7 The Deputy Director of Health Protection will attend quarterly Regional Specialty Committee meetings and report on health protection training activity for the quarter.

18.8 UKHSA South West Region are required to participate in the South West Quality Panel process and following the annual review meeting will maintain an action plan to address matters raised through this process. This will be monitored by the Deputy Director of Health Protection. 

 

APPENDIX 1 Guidance for methods of assessment for core health protection competencies

 

 

 

Key Area 6: Health Protection

 

 

 

Suitable assessment methods (Indicative)

 

 Aim: To identify, assess and communicate risks associated with hazards relevant to health protection, and to lead and co-ordinate the appropriate public health response.

 

Target phase

 

Related Learning

Outcome

 

 

MFPH Exam

 

 

WPBA

 

 

 

 

DFPH

MFPH

DOP

WR

CBD

MSF

 

6.1

Demonstrate knowledge and awareness of hazards relevant to health protection.

 

1

 

 

X

 

 

X

 

X

 

X

 

 

6.2

Gather and analyse information, within an appropriate timescale, to identify and assess the risks of health protection hazards.

 

1

 

KA 1.1, 1.6

 

X

 

X

 

X

 

X

 

X

 

 

 

6.3

 

Identify, advise on and implement public health actions with reference to local, national and international policies and guidance to prevent, control and manage identified health protection hazards.

 

 

1

 

 

KA 2.3, 2.4, KA 3 &KA 4

 

 

X

 

 

X

 

 

X

 

 

X

 

 

X

 

 

 

6.4

Understand and demonstrate the responsibility to act within one's own level of competence and understanding and know when and how to seek expert advice and support.

 

 

1

 

 

KA 9

 

 

 

X

 

 

X

 

 

X

 

 

X

 

 

6.5

Document information and actions with accuracy and clarity in an appropriate timeframe.

 

1

 

KA 1.2

 

 

 

X

 

X

 

 

 

 

6.6

Demonstrate knowledge and awareness of the main stakeholders and

agencies at a local, national and international level involved in health protection and their roles and responsibilities.

 

 

1

 

 

KA3

 

 

X

 

 

X

 

 

X

 

 

X

 

 

X

 

 

 

 

 

Key Area 6: Health Protection

 

 

 

 

Suitable assessment methods (Indicative)

 

Aim: To identify, assess and communicate risks associated with hazards relevant to health protection, and to lead and co-ordinate the appropriate public health response.

 Target phase

 Related curriculum areas with overlap

 

 

 

WPBA

 

 

 

 

 

 

Part A

 

 

Part B

 

 

DOP

 

 

WR

 

 

CBD

 

 

MSF

 

6.7

Demonstrate an understanding of the steps involved in

outbreak/incident investigation and management and be able to make a significant contribution to the health protection response.

 

Any

 

KA 1.6

 

X

 

X

 

X

 

X

 

X

 

 

 

6.8

 

 

Apply the principles of prevention in health protection work.

 

 

2

 

 

KA 1.9, 2.3, 2,5 & 5.9

 

 

X

 

 

X

 

 

X

 

 

X

 

 

X

 

 

 

6.9

 

Demonstrate competence to participate in an unsupervised out of hours (OOH) on-call rota.

 

 

2

 

 

 

 

 

X

 

 

 

X

 

WPBA – Work Place Based Assessment, DOP – Directly Observed Practice, WR – Written Report, CBD – Case Based Discussion, MSF – Multi-source

Feedback

 

APPENDIX 2: Assessment pro-forma for supervised on-call

 

Name of Candidate: Date of Assessment                                                

 

Name of Assessor 1 Placement Supervisor / Consultant in Health Protection

Name of Assessor 2 Senior Health Protection Practitioner

To pass the assessment for supervised on-call, the candidate must achieve an outcome of ‘Met’ for each domain.

 

Domain

 

 

Guidance on meeting requirement

Outcome(Met/Unmet)

Assessors comment

 

Assessment & confirmation of diagnosis details (based on information provided

-     Candidate makes an assessment about the information provided to inform risk assessment and further action required (e.g. source of information/limitations of information provided/ additional information required and where to get it.)

 

 

 

Knowledge of subject & guidelines to use

-        Demonstrates enough knowledge of scenario subject area to inform risk assessment and required out of hours action.

 

-        Knows which guidance to refer to inform risk assessment and required

 

 

 

 

 

out of hours action.

 

 

 

 

-

Refers to and uses guidance where knowledge on subject area is limited.

 

 

Initial risk assessment

-

Can define the associated hazard and its potential and likelihood to cause further harm to the public’s health/environmental damage.

 

 

 

 

-

Can define the population at risk.

 

 

Communications: Who to inform and when

-

Understand the need to report upwards to appropriate on-call tier and who to ask advice and support from.

 

 

 

 

-

Can identify relevant key people / agencies with whom to communicate directly or via the relevant on-call tier.

 

 

Immediate actions:

investigations & control measures required for out of hours response

-

 

Provides a comprehensive outline of the immediate actions/control measures to be taken out of hours.

 

 

 

-

Shows an understanding of the appropriate timescale to implement action/control measures required.

 

 

 

Follow-up work (for next working day)

-

Can outline additional follow-up action required ‘in-hours’ and how these should be recorded.

 

 

 

 

-

Can identify how to report and who to report additional actions require to.

 

 

NB Registrars may commence out-of-hours supervised on-call once they have successfully passed the FPH Part A examination and fully met learning outcomes 1.2, 4.2, 6.1 - 6.6, and 9.2 (the latter must be assessed in the health protection setting even if it has already been signed off in another placement) and successfully completed the assessment for on-call (as evidence to support required learning outcomes).

 

Is the candidate assessed as competent for supervised on-call Yes or No?   

 

 

 

 

Signed: (Assessor 1- Placement Supervisor / Consultant)

 

 

 

             Date:              

Signed: (Assessor 2 – Lead Health Protection Practitioner)

             Date:                          

 

 

APPENDIX 3 - Examples of formative assessment scenarios

 

Examples of communicable disease

scenarios, single cases of:

Examples of environmental incident

scenarios:

Meningococcal disease or meningitis

Water incident, e.g. contaminated water

supply

E coli O157

Fire involving asbestos

Legionella

Carbon monoxide incident

Measles

 

Diphtheria

 

Hepatitis A

 

Acute Hepatitis B

 

Inoculation injury

 

Invasive Group A Strep

 

Contact with rash during pregnancy

 

Animal bite, e.g. dog or bat

 

Outbreak of diarrhoea and vomiting

 

 

APPENDIX 4 Supervision Pro-forma

 

Date:

 

Supervisee:

 

Supervisor:

 

 

Agenda

 

1)    General Placement Issues / observations

 

 

 

2)    Acute Response Work & Case/Enquiry/Situation Review

 

 

 

3)    Project update

 

 

 

4)    E-portfolio / sign off

 

 

 

5)    AOB

 

  

 

Signed: Supervisee:                                                         /Date:            

  

Signed Supervisor:                                                          /Date:              

 

 

APPENDIX 5 - A 'knows-how' and 'shows-how' checklist to support Specialty Registrars in Public Health to develop a wider knowledge of the system of health protection (and show how this knowledge has been applied)

1. This checklist has been designed to aid Specialty Registrars in Public Health and their Educational Supervisors to maximise opportunities to understand (and demonstrate their understanding) of the system of health protection in the current health economy. It may provide further evidence of competence for Key Area 6 (and other relevant areas in the 2022 curriculum). This checklist should be completed before the end of Phase 2 and will be used to inform sign-off of competence 6.9 ‘demonstrate competence to participate in an unsupervised out of hours (OOH) on-call rota’ It also outlines opportunities for how StRs can complete this checklist.

1.1  Health protection is a fundamental tenet of public health delivery at local, national and international levels. Therefore, every educational /project supervisor has a role to play in supporting registrars to understand and improve their knowledge of the health protection system and relevant opportunities for them to show this understanding throughout their training.

1.2  Health protection training should start at the beginning of training at induction into the programme, through induction to Local Authority placements, formal teaching through the MPH/MSc as well as Part A preparation. Opportunities to understand the role of their host agencies in a system of health protection should be made at the earliest and where appropriate, specific project work agreed to enable StRs to apply knowledge acquired.

1.3  Additional training in this area will further enhance the current UKHSA placement.

The four-month full-time equivalent health protection placement and associated project work will remain protected time to cover placement specific outcomes of Key Area 6.

2.0 Know How Check list

 

Proposed Additional ‘Knows How’

 

Achieved by …

Civil Contingencies Act 2004 and duties of Category 1 and 2 organisations.

• •

Introduction to EPRR – UKHSA short course / tutorial

Self-directed study

Induction to placements

Role and functions of Public Protection/Environmental Health Teams within Local Authorities.

• •

Induction to placements

Project work

Self-directed study

Role and functions of Civil Protection Teams within Local Authorities.

• •

Induction to placements

Project work

Self-directed study

Role of Director of Public Health in discharging their responsibilities under the Health and Social Care Act 2012.

Induction to placements

Functions/Terms of Reference of the Local Resilience Forum and Local Health Resilience Partnership.

Self-directed learning Meeting attendance

Risk assessment process in relation to emergencies including knowledge of the Community and National Risk Registers and hazard identification.

Introduction to EPRR – UKHSA short course/tutorial Self-directed learning

Range of emergency plans at

LRF/Local Authority level and the

‘planning cycle’ in the context of

EPRR.

• •

Induction to placements

Project work

Self-directed study

Organisation Business Continuity

Plans/Planning including assessment and delivery of business-critical functions

• •

Induction to placements

Project work

Self-directed study

Risk communication in an EPRR context and wider communication strategies (e.g. warn, inform and advise approaches).

• • •

Introduction to EPRR – UKHSA short course/tutorial

Self-directed learning

Exercise participation

UKHSA Health Protection Placement

Command and control

arrangements including strategic, tactical and operational levels, their functions and how they are coordinated.

• •

Introduction to EPRR – UKHSA short course/tutorial

Self-directed learning

Exercise participation

Role/functions of the Scientific Technical Advisory Cell (STAC)

STAC Members Training – UKHSA short course

Self-directed learning

 

Exercise participation

 

Role/functions of Local

Induction to placements

Authorities in leading the

Introduction to EPRR – UKHSA short course/tutorial

recovery arrangements following

Exercise participation

response.

Self-directed learning

Role / functions of agencies who will be involved in response and recovery following an incident

e.g. Environment Agency, Food

Standards Agency, Animal &

Plant Health Agency

• •

Introduction to EPRR – UKHSA short course/tutorial

STAC Members Training – UKHSA short course

Health protection placement induction/placement

Joint Emergency Services Interoperability Programme and Joint Decision Model.

• •

Introduction to EPRR – UKHSA short course/tutorial

STAC Members Training – UKHSA short course Exercise participation

Incident declaration and escalation process.

Introduction to EPRR – UKHSA short course/tutorial STAC Members Training – UKHSA short course

 

Induction to placements

The functions of the air quality cell in support of an incident and sampling of other materials (e.g.

water/food) to inform a risk assessment.

Local Authority/UKHSA induction and placements/project work

Participation in exercises

Self-directed learning/agency visits

Environmental health roles, responsibilities, legislation, regulations, investigation, enforcement etc.

Local Authority/UKHSA induction and placements/project work

Participation in exercises

Self-directed learning/agency visits

Air quality and environmental protections, including land contamination etc. and links to LA planning role

Local Authority/UKHSA induction and placements/project work

Participation in exercises

Self-directed learning/agency visits

Arrangements for commissioning and provision of immunisation and vaccination programmes and assurance that locally identified needs are met

Local Authority/UKHSA induction and placements/project work

Visit to SCRIMS team

Self-directed learning/agency visits

Health Overview and Scrutiny in relation to health protection

Local Authority Placement

Routine surveillance systems used in the context of health protection

Local Authority Placement

3.0 Show How Checklist

 

Proposed Additional ‘Show

                                            How’

 

Achieved by …

Example of Linked Learning Objectives

•     Contribute to the development of an emergency or business continuity plan (e.g.

preparing, exercising or reviewing) within the Local Authority.

Local Authority placement. Core offer to CCG

  • 6.1 •           6.7
  • 6.8

•     Participate and reflect on a live major incident OR

Local Authority or UKHSA placement

  • 6.1
  • 6.2

emergency planning exercise

 

 

•      6.3

and debrief at either

 

 

•      6.4

tactical/strategic level.

 

 

  • 6.5 •           6.6
  • 6.7

•      Attend a Local Resilience

Forum/Local Health Resilience Partnership meeting and reflect through

case-based discussion/reflective summary

Local Authority or UKHSA placement

•      6.6

• Complete a risk assessment / review an existing risk assessment on the Community Risk Register ensuring local context for the risk is clearly outlined.

Local Authority or UKHSA placement

  • 6.2
  • 6,3

•     Undertake dynamic risk assessment during incidents, emergencies and outbreaks to guide appropriate public health action

Local Authority or UKHSA placement

  • 6.2
  • 6.3

• Use routine surveillance systems in relation to answer

Local Authority or UKHSA placement

•      1.1

a health protection query/question

 

 

•      1.5

•      Undertake at least one

Local Authority

•      4.8

collaborative project with the

Environmental Health/Public Protection team

 

placement.

•      6.6

 

4.0 Useful Supporting Reference Materials

Cabinet Office. 2013. HM Government Emergency Response and Recovery – Non-statutory guidance accompanying the Civil Contingencies Act 2004. Cabinet Office.

Cabinet Office. 2013. Expectations and Indicators of Good Practice Set for Category 1 and 2 Responders. Cabinet Office.

Cabinet Office. 2013. The Role of Local Resilience Forums: A Reference

Document. The Civil Contingencies Act (2004), its associated Regulations (2005) and guidance, the National Resilience Capabilities Programme and emergency response and recovery. Civil Contingences Secretariat.

Civil Contingencies Act 2004, Chapter 36. London: The Stationary Office. Department of Health. 2010. Health Protection Legislation (England)Guidance 2010. Department of Health.

Health and Safety Executive. 2022 Health and Safety at Work etc. Act 1974 [Online]. Available at: http://www.hse.gov.uk/legislation/hswa.htm [Accessed 11 November 2022]. 

JESIP Website http://www.jesip.org.uk/home

NHS England. 2022. NHS England Emergency Preparedness, Resilience and Response Framework. [Online] Available at:

https://www.england.nhs.uk/publication/nhs-emergency-preparednessresilience-and-response-framework/ [Accessed 11 November 2022]  

NHS England. NHS England National Incident Response Plan (published 2017)  [Online] Available at: https://www.england.nhs.uk/publication/nhs-england-incidentresponse-plan-national  [Accessed 11 November 2022] 

UKHSA. Health Protection A-Z [Online] Available at: https://www.gov.uk/topic/healthprotection. [Accessed 11 November 2022] 

UKHSA. Role and Priorities [Online] Available at:

https://www.gov.uk/government/publications/ukhsa-priorities-in-2022-to-2023 [Accessed 11 November 2022]

APPENDIX 6 - Guide for UKHSA staff and registrars carrying out health protection duties out of hours: Storing and transporting PII and confidential information off site

Purpose

  • to provide guidance on the storage and transport of confidential information or Person Identifiable Information (PII) for UKHSA staff and registrars working offsite and out-of-hours;
  • To ensure the safety of confidential and person identifiable information.

Background

UKHSA Health Protection staff and registrars are required to undertake out-ofhours health protection duties, working away from the office. Information, including PII may need to be written down on paper, either at home or occasionally in transit before being transcribed into HPZone. There may also be occasions where IT systems fail, and transcribing into HPZone is not immediately possible.

Legal requirements

All employees have a legal duty of confidentiality to keep PII and confidential information private, and not to divulge information accidentally.

UKHSA’s Records Management Guidance states that all individuals who work for UKHSA are responsible for any records which they create or use in the performance of their duties. All records created by a member of UKHSA staff belong to UKHSA.

The Data Protection Act 1998 requires personal data to be protected against unauthorised or unlawful processing and accidental loss, destruction or damage. There are a number of other statutory provisions which limit or prohibit the use of confidential information, and which require information to be shared.

The Caldicott Principles set out the principles under which information should be shared:

  1. justify the purpose;
  2. don’t use PII unless absolutely necessary;
  3. use the minimum necessary PII;
  4. access to PII should be on a strict need to know basis; 5. everyone should be aware of their responsibilities;
  5. understand and comply with the law.
  6. The duty to share information can be as important as the duty to protect patient confidentiality 

Guidance

The following are guidelines, which should safeguard PII and confidential information in most circumstances. However, circumstances vary and may require different actions, but UKHSA staff and registrars should always follow the principles of safeguarding confidential and PII data.

Working outside UKHSA offices

PII and confidential information (both paper and electronic formats) should be kept under constant control, so that other people cannot see the content or have access to the information.

Storage

If paper records are generated during periods of on-call they should be stored out of sight, preferably in a locked draw or filing cabinet. Other members of the household or friends/family must not be able to see the content or have access to the information. Completed paper questionnaires, or other paper notes should be entered onto HPZone as soon as possible, and then securely destroyed e.g. by securely transporting to the usual workplace and placing in confidential waste bins. This assumes that the place of work has sufficiently robust confidential waste disposal processes in place, if unsure ask you Educational Supervisor at the placement. Once information is transferred to HPZone these entries are considered the primary record and the paper notes can be destroyed.

Notebooks and paper used for in-office ARC days should be stored in a designated lockable cupboard. Notebooks and paper should therefore not need to be routinely transported.

Transporting PII or Confidential Information

If UKHSA staff and registrars need to travel with PII or confidential information they have personal responsibility to ensure the information is kept secure and confidential.

PII or confidential information must be kept out of sight whilst being transported. Paper records should be placed in a sealed non-transparent container e.g.

windowless envelope marked ‘confidential’ prior to being transported.

Notebooks or paper records (securely packaged) should be kept under the constant control of the employee while in transit. When travelling by car paper records should always be locked in the boot. When travelling by public transport the records must be kept on the person at all times. No PII  or  confidential information must  be left unattended.

Paper records should not be opened or reviewed while travelling on public transport or in public places.

Computers, laptops and phones

UKHSA laptops are password protected and encrypted. In general UKHSA staff and registrars must not store person identifiable or confidential information on a personal computer or device – if necessary it should be stored on a network drive.

If at all possible case information should be recorded directly onto HPZone. Only in exceptional circumstances should case information be recorded directly onto the local hard drive of a UKHSA or personal laptop or other device, if this does occur this information should be deleted immediately after it has been transferred onto

HPZone. Any case information backed-up to a non-UKHSA Cloud service or removable storage device (such as a personal USB memory stick or external hard drive) must also be securely deleted.

When working on a laptop or other devise UKHSA staff must ensure that the screen cannot be seen by anyone else. Personal information should never be viewed on a laptop or phone screen while travelling on public transport.

An unattended computer must be screen locked.

UKHSA staff and registrars must not send PII or confidential information to a personal e- mail account. PII or confidential information may be sent between UKHSA e mail accounts but not to nhs.net accounts from a UKHSA account. If it is necessary to send or receive PII from NHS colleagues (nhs.net to nhs.net accounts) enquire about using an nhs.net account that each health protection team may have access to. Separate local arrangements may be in place to transfer PII to local authority colleagues, please enquire about these arrangements if in doubt.

Phone calls

If UKHSA staff or registrars receive an out-of-hours call in transit on public transport, they should assess the urgency of the call and take essential details without breaching confidentiality i.e. not mentioning people’s names etc. while on public transport. Based on this assessment a decision can be made regarding the urgency with which the call needs to be followed up. If necessary, it may be appropriate to pass the call to another member of the on-call team who is in a more suitable position to deal with it or follow up may be delayed until the journey is complete and the member of staff is in a more suitable environment to deal with it.

Registrar Training Competencies

Confidentiality is covered under competencies 1.2 and 9.10 in the 2022 training curriculum for SpRs. The full curriculum is available here: public-health-trainingcurriculum-2022-final.pdf (fph.org.uk)  

Registrar Log Books

Registrars are required to keep an On-call Logbook.

The  Academy  of  Medical  Royal  Colleges  provides  the  following  advice  on  how logbooks and reflective notes should be anonymised:

Other practitioners, patients, parents and staff should not be named or be readily identifiable from the information you provide. For example, instead of referring to patient Jane Smith, refer to them as patient X. Never include the patient ID number or name. Avoid including date of birth (if necessary refer to the patient’s approximate age), addresses or any unique condition or circumstance of that patient which may allow someone to identify them when used in conjunction with other information they have access to. Occasionally it will be unavoidable as the condition of a particular patient will be unique, but try and minimise the patient identifiable information that you provide.

http://www.aomrc.org.uk/wp-content/uploads/2016/11/Academy_Guidance_on_e- Portfolios_201916-5.pdf

Educational Supervisors Educational Supervisors should:

  • ensure  that  registrars  are  aware  of  their  obligations  to  keep  PII  and confidential information safe as outlined in this document;
  • ensure   that   registrars   have   under   taken   the   appropriate   information governance training including their annual update;
  • Check their registrar’s logbook to ensure information has been appropriately anonymised. 

APPENDIX 7 - Pre-mandatory training placement meeting agenda/learning agreement

  

Name:                                                          Year:                                              Date:

Plan duration:

Placement supervisor:

Training Programme Director:

 

Items

Detail

Plan

Reasonable Adjustments

Required to Support Placement / Learning (e.g.

physical adaptations / support)

 

 

Honorary Contact (set-upprior to placement

commencement and send to

Diane Lloyd)

 

 

Previous health protection experience

 

 

 

Exam milestones for currentphase

 

 

Phase-based learningoutcomes to achieve

 

 

Generic skills to achieve

 

 

 

 

Signed (Registrar):

 

 

 

 

Date:

Signed (Placement Supervisor)

Date: