The North West Public Health on Call Review

Background

Health Protection (HP) focuses on the prevention and control of communicable disease and the public health response to chemical and radiation hazards to health.

The HP function in each locality is a PCT and local authority responsibility, with support from others including NHS Trusts, and is discharged with the leadership advice and support of the Health Protection Agency (HPA). This paper refers to the out-of-hours cover for the PCT public health function (‘on-call’).

Provision of an on-call service is a joint responsibility between PCTs and the HPA, as agreed by the Faculty of Public Health (FPH) Working Group on Health Protection and reinforced by the national template Memorandum of Understanding between PCTs and the HPA.

Out of hours cover for this function has usually been part of the local Public Health on-call rotas and most PCTs in England currently share Public Health on-call arrangements with neighbouring PCTs. Modern on-call models usually recognise mechanisms for providing mutual aid, escalation of response and mobilising continuing response and surge capacity.

Approach

The Cheshire and Merseyside Directors of Public Health, in liaison with Mersey Deanery, Regional Director of Public Health, public health trainees and Cheshire and Merseyside Health Protection Unit, commissioned HM Partnerships to develop a short paper reviewing the current public health on-call system and consider options to support the development of a new system that is fit for purpose and fulfils modern public health practice requirements.

Alongside identifying and examining related and relevant literature and interviewing key stakeholders and informants, the review considers related national and regional guidance and options for public health on-call system delivery.

The review will seek to make recommendations about payment for individuals on the rota (including recharges to PCTs) and make recommendations covering ongoing and future governance, coordination, and management arrangements for rota.

Findings

HM Partnerships conducted a detailed options appraisal which outlined the number of viable options for the delivery of a new public health on call system, all options were scored and recommendations made.