Management Commentary

About the Health Protection Agency

 

Our Role

On 1 April 2005, the Health Protection Agency Special Health Authority and the National Radiological Protection Board merged to become the Health Protection Agency as an Executive Non-Departmental Public Body; an independent specialist organisation dedicated to protecting the health of the population of the United Kingdom. We do this by providing impartial advice and authoritative information on health protection issues to the public, to professionals and to government. Everything we do is based on expert skills and knowledge applied to strong front-line services. We work at international, national, regional and local levels to identify new threats to health, to prepare for them, prevent them where possible, and should they arrive reduce their impact on public health. We combine public health and scientific expertise, research, and emergency planning within one organisation.

We provide an integrated approach to protecting UK public health through the provision of support and advice to the NHS, local authorities, emergency services, other Arms Length Bodies, the Department of Health and the Devolved Administrations.

 

Our role includes:

 

• Providing impartial expert advice on health protection and providing specialist health protection services

• Identifying and responding to health hazards and emergencies caused by infectious disease, hazardous chemicals, poisons or radiation

• Anticipating and preparing for emerging or future threats

• Supporting and advising other organisations with a health protection role

• Improving knowledge about health protection through research and development, education and training.

 

Staff

During 2005/06 the Agency employed 3,217 staff. They are based in three centres (Colindale, north London; Chilton, Oxfordshire and Porton Down, Wiltshire) and in locations across England, Wales, Scotland and Northern Ireland . The Agency's headquarters are based in London .

Agency staff include doctors and nurses, scientific and technical staff from many specialist disciplines, administrative staff and emergency planners. They work with colleagues in corporate affairs, finance and resources, communications and human resources divisions.

 

Medical - 260

Nursing - 180

Professional & Administrative - 847

Scientific - 590

Technical - 1135

Agency - 205

Overall Total - 3217

 

Organisational Structure

 

 

Centre for Infections

The Centre for Infections, based at Colindale, north London , is responsible for a number of essential frontline national services including:

 

• Infectious disease surveillance

• Providing specialist and reference microbiology and microbial epidemiology

• Co-ordinating the investigation of national and cross-regional outbreaks

• Helping advise government on the risks posed by various infections and responding to international health alerts.

 

It monitors unusual disease outbreak activity, and carries out typing and fingerprinting of infectious agents. This is done by working closely with partner organisations in the UK such as the Veterinary Laboratories Agency for infections transmitted from animals, and international bodies such as the World Health Organisation and the new European Communicable Disease Centre as well as other parts of the Health Protection Agency.

At the local level, the Centre provides expert support to colleagues in Local and Regional services) and the Regional Microbiology Network as well as directly supporting customers.

Expert staff are on-call 24-hours a day for normal business and to ensure an immediate response to national emergencies. The Centre also provides commercial services, expert disease modelling, quality assurance schemes, training, and has an active research programme.

 

Centre for Emergency Preparedness and Response

The Centre for Emergency Preparedness and Response manages the Agency's Centre at Porton Down, Wiltshire. The Centre co-ordinates emergency preparedness across the Agency and it works closely with the NHS, local authorities and the emergency services, identifying and strengthening countermeasures. Exercises to test responses are conducted across the country with UK and EU partners, further improving emergency planning and preparedness. A major training programme is conducted for health professionals in chemical, biological, radiological and nuclear scenarios and casualty management.

The Centre models disease, particularly for agents considered a bioterrorism threat. It has high containment laboratories for diagnosis of imported dangerous pathogens like Ebola or agents which could be used in a deliberate release. It conducts research on vaccines and diseases such as tuberculosis and meningitis, and on prions. Anthrax vaccine is manufactured for the UK Government and defence vaccine research is carried out for the UK and US Governments.

 

Centre for Radiation, Chemical and Environmental Hazards

The Centre for Radiation, Chemical and Environmental Hazards is based in Chilton, Oxfordshire, with a number of offices and laboratories in Birmingham, Cardiff, Leeds, London, Glasgow and Newcastle protection serving regional needs. The Centre has two divisions; radiation, and chemical hazards and poisons. They cover a diverse range of issues associated with the risks to public health resulting from exposure to noxious chemicals and poisons, and to ionising/non-ionising radiations.

Key functions include: advice, research and the provision of services; the assessment of exposures and the consequent risks to health; advising government, other bodies and the public on these risks; providing an input to emergency preparedness and response; providing training and other commercial services and working in partnership on health protection issues with other national and international bodies. The Centre also provides advice and support within the Agency, particularly to staff in Local and Regional Services who, with primary care trusts, respond to local incidents and public concerns.

The Centre provides advice to UK Government Departments and Agencies on the impact to human health from chemicals in water, soil and waste as well as information and support to the NHS and health professionals on toxicology. The Centre is undertaking intensive research to improve our understanding of long-term consequences of low level, chronic exposure to chemicals and poisons especially in relation to reproductive health, asthma and cancers.

Guidance is available round-the-clock from medical toxicologists, clinical pharmacologists, environmental scientists, epidemiologists and other specialists. The Centre also advises doctors and nurses on the best way to manage patients who have been poisoned. It provides this service through the National Poisons Information Service.

 

Local and Regional Services

Local and Regional Services (LARS) has responsibility for working with key stakeholders at local and regional levels to provide specialist health protection advice and operational support directly to all primary care trusts, strategic health authorities, regional directors of public health and all local authorities in England. Support to Northern Ireland is also provided and there is a close working relationship with many other government agencies in England . LARS works to ensure health protection security and to reduce the burden of disease. It does this by responding to and controlling some 2,500-3,000 infection and environmental incidents and outbreaks each year, assisting in tackling infections such as MRSA, tuberculosis and sexually transmitted infections. LARS also actively engages in the Agency's preparedness and response to emergencies, from flooding to the deliberate release of biological and/or chemical agents. It is heavily involved in developing training both internally and externally, aiming to improve practice, overall capacity and leadership in health protection.

Local and Regional Services are provided through nine Regional Offices (which correspond to the Government Offices of the Regions) and

There are 30 Health Protection Units (HPUs), each covering an area with a population of about 2 million. Each unit has a director, consultants, nurses and other staff with specialist health protection skills. They have access to expert advice from the other centres and divisions in the Agency.

The task of each HPU is to work directly with NHS primary care trusts (PCTs), acute hospital trusts and local authorities in their area and agree with them how health protection should be delivered locally. Functions include local disease surveillance, laboratory services, alert systems, investigation and management of the full range of health protection incidents and outbreaks, and ensuring local delivery and monitoring of national action plans for infectious diseases.

 

Regional Microbiology Network

The Regional Microbiology Network incorporates all the Agency Regional Microbiology Laboratories, Food, Water & Environmental Laboratories and Collaborating Laboratories.  These laboratories provide frontline microbiology services and support outbreak investigations.  The Regional Microbiology Network has extensive links with the Centre for Infections, Centre for Emergency Preparedness and Response and the National Institute for Biological Standards and Control (NIBSC) to facilitate the co-ordination of microbiology services within the Agency.

 

Corporate Services

The three Centres, LARS and the Regional Microbiology Network are supported by four divisions within corporate services:

 

Finance and Resources

The Finance and Resources Division includes the departments of Finance, Estates and Facilities, Information Systems, Information and Knowledge Management, the International Office and Internal Audit. The Division provides the Agency with efficient, effective and economic financial and resource management services to enable the Agency to achieve its strategic goals.

The first two years of the Agency's existence involved harmonising and standardising basic systems. During 2005/06 the Division implemented a new financial management system across the organisation, which will provide more accurate information and cost savings and upgraded the IT infrastructure to improve communications across the Agency.

 

Corporate Affairs

The Corporate Affairs Division supports the Board and the Executive on secretariat matters and takes the corporate lead in a number of Agency activities, including business planning and risk management, governance, health and safety, quality and environmental policy, security, legislation and non-commercial legal issues. The division also manages the Agency's complaints procedure, subject access requests under the Data Protection Act and requests under the Freedom of Information Act. The Expert Advisory Support Office also provides scientific secretariat services to a number of Department of Health Advisory Committees.

 

Communications

Press office teams provide a nationwide round-the clock service to the Agency, its stakeholders and the media, ensuring that advice and information is timely, authoritative, consistent, accurate and clear. The Communications Division deals with hundreds of press enquires each month leading to between 500 - 800 mentions in the print media and facilitates an average of 100 - 150 broadcast and print interviews each month.

Specialists in publications, design, branding, stakeholder engagement, public involvement and internal communications provide comprehensive support for the Agency's work at all levels, from local and regional to national and international. The Division strives to ensure that the Agency's communications activities, whether advice, information, publications or stakeholder communications, fully support, enhance and take forward its strategic goals and priorities and contribute to their successful delivery.

 

Human Resources

The Human Resources Division provides operational support for all parts of the Agency. The Division has led the implementation of the Agenda for Change programme with the welcome and widespread support of trade union colleagues. The Division has also conducted an Employee Opinion Survey across the Agency which resulted in a good response rate, and valuably highlighted a number of areas for improvement. The plans for remedial action are in place and will be implemented in partnership with all interested parties.

 

Additional Corporate Information

Human Resources Policies and Process Development

The Agency continues to develop a wide range of policies and processes in partnership with staff representatives, designed to improve the employment experience of Agency staff and to assist the organisation in meeting its objectives.

Recent initiatives include development of policies to improve the work life balance of employees, for example flexible working and flexi-time policies. The Agency has also placed an increased emphasis on employee development through the introduction of a new appraisal process supported by a comprehensive employee development and support policy.

 

Employee relations

We promote positive employment relations with staff and their representatives and a Recognition and Procedure Agreement has been entered into with the relevant trade unions. The bi-monthly meetings of the National Joint Staff Committee, which is made up of management and staff-side representatives, provide a valuable mechanism for on-going constructive consultation on the Agency's wide range of issues and developments.

 

Communications with employees

The Agency is committed to regular informed communications with its employees at all levels. This is carried out by the human resources and the communications divisions using a variety of means, both formal and informal. This aims to ensure the regular and clear communication of information that may impact upon employees' working and professional lives.

 

Equality and diversity

The Agency undertakes to promote equality and diversity and not to discriminate between employees or job applicants in respect of age, sex, sexual orientation, marital status, race, colour, ethnic or national origin, disability, religion, gender reassignment, HIV status or trade union membership.

The Agency has established a working group to look at all Equality and Diversity issues within the organisation. The group was established initially to look at Race Equality issues as the organisation is bound under the Race Relations (Amendment) Act 2000 although its remit has recently expanded to look at all equality and diversity issues.

The group is currently working on a number of issues including an audit of Human Resources and non-Human Resources policies, a leaflet to be given to all existing and new staff, equality and diversity training, an equality statement to go on job descriptions, a report on recruitment issues and the sourcing of equality information on staff for monitoring purposes.

 

Persons with disabilities

The Agency's policy in respect of people with disabilities is incorporated into its Equality and Diversity Policy. The Agency takes all practicable steps to ensure that it meets the requirements of the Disability Discrimination Act 1995. Relevant principles and practices are incorporated into training programmes for staff involved in recruitment and selection procedures.

 

Health and Safety

The Health Protection Agency complies with all relevant legislation and regulations concerning Health and Safety at Work.

Good progress has been made with the Corporate Health and Safety Plan this year and Division and Centre action plans have also been developed. Regular review and updates of these plans will ensure that compliance is maintained and that continuous improvements are made.

Numerous corporate Health and Safety policies have been developed and launched this year as part of our programme of introducing a more consistent approach to Health and Safety across the Agency. These policies have been communicated to all staff via line management and are also available on a new Health and Safety intranet site, also launched this year.

Our comprehensive programmes of audits, inspections, risk assessments and training has continued this year, as has the Agency's commitment to ensuring that safe and healthy working conditions continue to be provided for employees and contract staff, and for visitors.

 

Environmental Management and Sustainability

As a Non-Departmental Public Body, the Agency acknowledges and fully supports the UK Government's commitment to sustainable development. As a major part of this, the Agency has developed a programme to ensure that it delivers on the commitments made in its Corporate Environmental Policy. A strategy has been developed which will ensure that appropriate environmental management systems are implemented, key performance indicators are established and through these, continual environmental performance improvement is achieved.

The Environmental Strategy Group continues to lead on this process on behalf of the Executive and Board. The strategy includes appropriate environmental initiatives and a prioritised implementation plan for developing and improving our performance in several key areas such as procurement, energy and water use, waste management, travel and the estate and social impacts.

There has been progress in many areas this year, for example:

 

• We have been working with the Department for Environment Food and Rural Affairs (DEFRA) and will be contributing to the pan-government fund established to offset carbon dioxide emissions from air travel. These contributions will commence based on the air travel undertaken in the 2006/07 financial year.

• We have invested significantly in electronic communication facilities, which will facilitate better communications and emergency operational support. However, it is also envisaged that this investment will allow a reduction in business travel and hence environmental emissions.

• We engaged the Carbon Trust to complete energy usage reviews at our three main sites this year. Where reasonable and practicable, actions are now being taken to address the recommendations made in these reports.

 

We have introduced a Green Transport Policy at our Centre for Emergency Preparedness and Response and will be looking to extend this principle to our other main sites wherever possible.

During the year ahead we will be making more improvements in several key areas, our aims include:

 

• To introduce an Agency energy policy. This will outline our approach to achieving better utilisation of natural resources. As part of this initiative, we will also be pursuing a single contract to purchase 'green' electricity.
• To continue the development of our sustainability policies, the Executive will also be considering the development of a more formal Sustainable Development Action Plan for publication during the year.
• To achieve better communications on environmental activities, both internal and external, to engage with staff and stakeholders on what we are already doing and what can still be done. We will be launching a new Environmental Intranet site, through which staff can participate in the environmental activities and initiatives that will be launched during the year. Another focus will be the provision of information to our staff to raise awareness of how their actions affect the environment, hence improving environmental performance.

 

Research and Development

The Agency uses research and development expertise to underpin its authoritative evidence based advice and, working in partnership with the commercial and public sectors, to deliver new treatments which benefit public health. During the year the Agency published Providing the Evidence Base for Public Health; The Health Protection Agency's Research Strategy 2005-10 which outlined the main functions and unique research and development capabilities of the Agency and a framework to guide the Agency and partner organisations on productive areas for research and development.

 

Business

A significant proportion of the Agency's income comes from commercial activities including microbiological, chemical and radiological testing, research and development contracts, custom biopharmaceutical manufacture, consultancy and training, as well as products including diagnostic kits and therapeutic medicines.

 

Performance Indicators

The Agency has developed a number of key corporate performance indicators (KPIs) and, using the established programmatic approach to health protection priorities, will further develop KPIs to reflect the health outcomes of the Agency's work. These developments will be conducted in hand with the Department of Health's 'balanced scorecard' initiative to be introduced in 2006/07

 

Information Access Requests

During 2005/06 the Agency received 126^* information access requests, including requests transferred to the Agency from other public authorities.

Most requestors cited the Freedom of Information Act but the figure also includes requests handled in part or exclusively under other information access legislation. Specifically, four requests were handled under the Environmental Information Regulations and seven were subject access requests for personal information (made by the data subject or agents acting on their behalf) and were handled under the Data Protection Act. In addition three requests were made under the Re-use of Public Sector Information EU Directive.

* Additional information requests from an individual on the same subject were counted as part of the original request. There were six such requests in 2005-06.

 

Parliamentary Questions

A total of 197 Parliamentary Questions (PQs) were referred to the Agency during 2005/06. Most were referred by the Department of Health, and a few by the Food Standards Agency.  In 2005, PQs were also referred by the Department for Environment, Food and Rural Affairs and HM Treasury. 

PQ topics for this period include tuberculosis, Hepatitis, HIV and AIDS, sexually transmitted infections, chemicals, gastrointestinal infections, infections in patients and staff in hospitals and care homes, and antimicrobial resistance. 

Six requests concerning radiation matters were dealt with separately by the Centre for Radiation Chemical and Environmental Hazards. They included the possible health effects of mobile phones or masts, UV exposure and the national chemical biological network alerting system.

 

Complaints

Thirteen complaints were received from members of the public, patients and service users during the year and were handled in accordance with the Agency's Complaints Procedure
(http://www.hpa.org.uk/hpa/foi/PDFs/complaints_procedure.pdf ). Of three complaints outstanding from the previous year, one was resolved, one was referred to the Information Commission and one remains outstanding

 

Stakeholder Relations

The Agency has mapped out its key stakeholders p81 and senior managers have been identified as the lead contact for each of these. One of the responsibilities of this group will be a review of the health of these stakeholder relationships. This is being completed in 2006/07 together with the establishment of a more formal framework to monitor and develop relationships with key stakeholders

Despite the lack of a formal framework most relationships have been managed well with much work already invested in them and these continue to grow and develop. A good example of this is the strengthening links with the Environment Agency which includes a formal Memorandum of Understanding, a joint five year action plan and co-operation at a local level in response to chemical spills and waste management. Other relationships such as those with both national and local press and media are by nature much less formal.

 

Stakeholders

 

Government Departments	Dept Health Defra DfID Food Standards Agency Cabinet Office FCO Home Office HM Treasury DTI DFT MOD DfES ODPM (until 5 May 2006) Department for Communities and Local Government
Government Agencies	Environment Agency Health and Safety Executive National Institute for Biological Standards and Control Veterinary Laboratory Agency Security Services Prison Service Medicines & Healthcare Products Regulatory Agency National Patient Safety Agency National Institute for Clinical Excellence
Other Public Sector	Local authorities Government Offices in the Regions Police Service Fire Service National Audit Office
Devolved Administrations/Counterpart Bodies	National Assembly for Wales Scottish Executive Northern Ireland Health Protection Scotland NPHS for Wales Republic of Ireland - 5 nations group
International	Governments WHO Central and Regional Counterpart organisations e.g. Health Canada , CDC, CHP Hong Kong) Regional Government Bodies and their Health sectors EC DG Sanco, others Other European Agencies e.g. EFSA Other UN bodies (UNAIDS, UNICEF) Other health organisations e.g. OIE Other organisations, e.g. NATO Int. Commission on Non-Ionising Radiation Protection Int. Commission on Radiological Protection Global Health Security Action Group International Committees ROI (joint working with NI)
Health Service Bodies	Primary Care Trusts Strategic Health Authorities Acute Trusts Regional Directors of Public Health GPs NHS Direct Public Health Observatories Other health professionals (Infectious disease, A&E etc) National Blood Service NHS Hubs (e.g. Trust TECH) Post-graduate deaneries
Not for profit sector	Charities Voluntary Organisations Non-Governmental Organisations
Academia/professional	Universities, colleges, schools Professional institutions Professional (craft) groups Training bodies Professional societies
Parliament	MPs House of Lords Parliamentary Committees MEPs
Public	Press and media Individuals
Private Sector	Companies Manufacturers Trade associations
Employee groups	Trades Unions NHS Confederation
Types of relationship: Regulatory, Statutory, MOUs/SLAs, Informal, Formal, Individual, Corporate, Common Interest, Contractual, Legal, Professional network and collaborative R&D.