Version: 4.0. Employment Policy On Protection Against Infection With Blood-Borne Viruses. Name of Policy: Effective From: 13/03/2013

Transcription

1 Policy No: PP22 Version: 4.0 Name of Policy: Employment Policy On Protection Against Infection With Blood-Borne Viruses Effective From: 13/03/2013 Date Ratified 04/02/2013 Ratified Human Resources Committee Review Date 01/02/2015 Sponsor Deputy Chief Executive/Director of Transformation and Complian Expiry Date 03/02/2016 Withdrawn Date This policy supersedes all previous issues.

2 Version Control Version Release Author / Reviewer Ratified by/authorised by 1.0 Aug 2000 JCC, Trust Board and Control of Infection Committee Date Jul 2000 Changes (Please identify page no.) 2.0 Jul 2006 K Ward JCC Jul /02/2011 K Ward Human Resources Committee /03/2013 K Ward HR Committee 14/02/ /02/2013 Employment policy on protection against infection with blood-borne viruses v4 2

3 Contents Section Page 1 Introduction 4 2. Policy scope 4 3. Aim of policy 5 4 Duties (Roles and responsibilities) 5 5 Definitions 6 6 The Infected Health Care Worker Conditions of Service Confidentiality Health and Safety Information Education of Staff 7 7. Training 7 8. Equality and diversity 8 9. Monitoring compliance with the policy Consultation and review 8 11 Implementation of policy (including raising awareness) 8 12 References 8 13 Associated documentation (policies) 8 Appendix 1 Procedure For Recruitment And Selection Of New 9 Employees Who Will Be Involved In Exposure-Prone Procedures Employment policy on protection against infection with blood-borne viruses v4 3

4 1 Introduction 1.1 Gateshead Health NHS Foundation Trust is committed to maintaining the Health and Safety of its patients and staff. This policy describes the way in which the Trust protects staff against occupationally acquiring a blood borne viral infection, and the action to be taken should an incident occur where transmission of a Blood Borne Virus to a patient could have taken place. 1.2 It is derived from Department of Health Guidance (HSG (93)40) and Guidance for Clinical Health Care Workers (Recommendations of the Expert Advisory Group on AIDS and the Advisory Group on Hepatitis 2005), Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers and reinforces existing infection control guidance to protect and promote the health and welfare of its Trust employees. Furthermore, it sets out the notification procedures which should apply should any patient be found to have been treated by an infected health care worker. As part of its approach to the management of infected health care workers, the Trust will also work in accordance with the requirements of HSC 2000/ The Equality Act 2010 makes it unlawful to discriminate against disabled persons including those infected with blood borne viruses in any area of employment, unless the employer has justification, which amounts to a material and substantial reason. The restriction of such a worker for the purpose of protecting patients from risk of infection, such as the requirement to refrain from performing exposure prone procedures, would justify discrimination. However, where the employer knows that the worker is disabled, there is a duty to make a reasonable adjustment, e.g. by moving the worker to a post, if available, where the worker and patients would not be placed at risk. 2 Policy scope 2.1 This policy document sets out the arrangements, which will apply within the Trust in relation to the employment of existing or prospective employees who develop or who are found to be infected with blood-borne viruses (BBVs). This policy also applies to doctors employed by the Lead Employer Trust working within GHNHSFT, visiting health professionals and students attached to the Trust. The term staff will be used throughout the remainder of this policy to refer to all of these groups. 2.2 There will be no discrimination in recruitment or continued employment against present or prospective employees on the grounds that the applicant/employee has a blood-borne virus (BBV). However, where prospective or current employees are to be involved in exposure-prone procedures, the procedure set out in Appendix I of this policy will, at all times, be followed. 2.3 This policy highlights the need to protect patients; to retain the public s confidence; and to provide safeguards for the confidentiality and rights of infected staff. 2.4 Under the Health and Safety at Work Act (HASWA) 1974 staff have a duty to take reasonable care of themselves and others. Under this duty staff will be required to follow the Trust's arrangements set out in this and all Trust policies for managing the risks associated with blood borne viruses. All staff who have direct clinical care of patients have a duty to keep themselves informed and updated on the Codes of Professional Conduct and guidelines on BBV infection laid down by their regulatory bodies. Employment policy on protection against infection with blood-borne viruses v4 4

5 3 Aim of policy To support staff who have BBVs and to prevent onward transmission to any patients. 4 Duties (Roles and responsibilities) 4.1 Trust Board Responsibilities The Trust Board is responsible for compliance with all policies within the Trust under Care Quality Commission, NHSLA standards and all relevant legislation. 4.2 Managers Responsibilities It is the responsibility of managers to promote the health of both patients and staff and to ensure that staff are aware of this policy and their responsibilities in relation to protecting patients from the onward transmission of infection. 4.3 Occupational Health Department Responsibilities The Occupational Health Department is responsible for: carrying out relevant screening in accordance with Department of Health guidelines; raising staff awareness of the requirements of this policy; supporting managers and staff in dealing with BBV situations; providing immunisations, tests and advice. 4.4 Personnel Department Responsibilities It is the Personnel Department responsibility to ensure any necessary redeployment is handled sensitively, in accordance with policy requirements. 4.5 Employees Responsibilities Employees must protect patients from onward transmission of BBV by adhering to this policy, control of infection policies, relevant professional codes of conduct and any additional guidance issued in the course of their employment Health Care Workers have an ethical duty to protect patients. Those staff who work in exposure prone areas are required to provide information when requested by the Occupational Health Department on their BBV status Those who believe they may have been exposed to infection must seek and follow medical advice immediately and, if appropriate, undergo diagnostic or antibody testing. Infected health care workers should not undertake procedures, which may place patients at risk of infection. Those who perform or assist in exposure prone procedures must obtain appropriate medical and Occupational Health advice on their work practices as these may need to be modified or restricted to protect patients Workers who are found to be infected and who perform exposure prone procedures must cease these activities immediately and inform the Occupational Health Department or outside of opening hours the on call director who will inform, on a Employment policy on protection against infection with blood-borne viruses v4 5

6 strictly confidential basis, the Chief Executive and relevant Divisional Director. Appropriate action will be decided in the light of the circumstances of the case Infected Health Care Workers who continue to work with patients must remain under close medical supervision and receive appropriate medical and occupational health advice as their circumstances change. Such staff must not rely on their own assessment of the risk they pose to patients Staff are advised to refer to and adhere to their own professional regulatory body s guidelines on BBVs Staff who know or have good reason to believe (having taken steps to confirm the facts as far as practicable) that a health care worker practicing has a blood borne virus infection and is practising in a way which places patients at risk, or has done so in the past, should inform the Trust s Occupational Health Department in confidence. Wherever possible, the health care worker concerned should be informed before this action is taken. 5 Definitions Exposure prone procedures are those where there is a risk that injury to the worker may result in the exposure of the patient's open tissue to the blood of the worker. These procedures include those where the workers gloved hands may be in contact with sharp instruments, needle tips and sharp tissues (spicules of bone or teeth) inside a patient's open body cavity, wound, or confined anatomical space where the hand or finger tips may not be completely visible at all times. Such procedures must not be performed by a Health Care Worker who is infective with blood borne virus (assessment of this risk will be undertaken in accordance with current Dept of Health guidance). The working practices of each infected Health Care Worker must be considered individually and when there is any doubt expert advice should be sort in the first instance from a specialist Occupational Health Physician who may in turn consult the Advisory Panel on Infected Health Care Workers. 6 The Infected Health Care Worker 6.1 Conditions of Service If it becomes known that an employee is infected, the Trust will ensure that resources are made available to provide adequate support, as far as is reasonably practicable, to enable work to be continued in accordance with Department of Health Guidance. Confidential advice will be given by the Occupational Health Department The Trust will endeavour to provide or gain access to counselling services for infected employees through either in-house arrangements or external organisations and allow, if necessary, for this to happen during working hours No employee will be redeployed against their own wishes on the basis of having a BBV unless they are putting patients or themselves at risk or are deemed to be not 'medically fit' for the particular duties that they are contracted for. Should redeployment be necessary, mutual agreement between the employee and employer will be sought. Employment policy on protection against infection with blood-borne viruses v4 6

7 6.1.4 Normal arrangements for early retirement on health grounds will apply. The Trust's normal rules concerning sickness absence will continue to operate for those employees infected with BBV. 6.2 Confidentiality Confidentiality is clearly of paramount importance in the implementation of this employment policy. If managers or other staff learn of an individual's infected health care status they must ensure that this information remains confidential. The Consultant Microbiologist will give all staff related results to the Occupational Health Department only except if the Department is closed when the Consultant Microbiologist will need to make a decision as to whether there is a need to give advice to the Medical Director or Director on-call either with the individual's informed consent, or in circumstances where the safety of patients, relatives and/or colleagues is deemed to be at risk. Such a decision must be carefully weighed. The expert advisory Groups on AIDS and Hepatitis consider that only in very exceptional circumstances may disclosure without consent be justified and those making such a disclosure may be required to justify their action. Any deliberate breach of confidentiality will be against the Trust's policy and will constitute a disciplinary offence The fact that the infected worker may have died or may have already been identified publicly does not mean that duties of confidentiality are automatically at an end. 6.3 Health and Safety In accordance with the Trust's Risk Management Strategy, the Trust will ensure that suitable precautions and systems are maintained and adhered to which will guard against any risk of BBV infection in the workplace. 6.4 Information The Trust will take all reasonable steps to provide accurate information which can assist in reducing any misunderstanding or fears about the risk of infection, together with reducing any fears or prejudices in relation to those thought to have BBV infection. The Occupational Health Department will provide confidential advice and information to all staff if requested. 6.5 Education of Staff The Occupational Health Department will send annual reminders to all staff via and newsletters that they have a duty to seek medical advice if they believe they may have been exposed to infection. 7 Training A protocol detailing action to be taken if an infected health care worker is identified will be available to on-call Directors, the Chief Executive, Consultant Microbiologist, the Medical Director, Divisional Directors and appropriate staff in the Occupational Health and Personnel Departments. Employment policy on protection against infection with blood-borne viruses v4 7

8 8 Equality and diversity The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds. As part of that commitment, the Trust aims to ensure policies and procedures that are intended to protect the health and wellbeing of patients, does not directly or indirectly discriminate against disabled staff. This policy has been appropriately assessed. 9 Monitoring compliance with the policy This policy will be reviewed in line with the attached review schedule by the JCC Policy Sub-Group and if necessary the review timescale will be amended to incorporate new guidance and good practice. Standard/process/issuMonitoring and audit Method By Committee Frequency Pre employment health Audit Occupational HRC Annually screening carried out against current Department of Health guidance and Report Health 10 Consultation and review This scheme has been reviewed in consultation with the JCC Policy Sub-Group. 11 Implementation of policy (including raising awareness) This scheme will be circulated by the Trust Secretary as detailed in OP 27 Policy for the development, management and authorisation of policies. 12 References Health and Safety Executive Guidance: HSG (93)40 Department of Health Guidance: Guidance for clinical health care workers: protection against infection with bloodborne viruses recommendations of the expert advisory group on aids and the advisory group on hepatitis and hepatitis c infected health care workers Health clearance for tuberculosis, hepatitis B, hepatitis C and HIV: New healthcare workers Equality Act 2010 Risk Management Strategy. 13 Associated documentation Infection Control policies and procedures. Employment policy on protection against infection with blood-borne viruses v4 8

9 Appendix 1 Procedure For Recruitment And Selection Of New Employees Who Will Be Involved In Exposure-Prone Procedures 1. This procedure note applies to all new employees (including locum staff) who are appointed to posts involving participation in exposure-prone procedures. Separate guidelines exist relating to the employment of Specialist Registrars within the Trust. 2. Locum Staff 2.1 For locum staff, the Trust will require all locum agencies to provide assurance on an annual basis that they accept responsibility for ensuring that any locum identified to perform exposure prone procedures will be screened in line with current Department of Health guidance. The responsibility for ensuring such confirmations are sought will rest with the Head of Personnel. 2.2 If the Personnel Department/Director on-call is informed by the locum agency or Occupational Health Department that the potential locum is not BBV cleared, the relevant Consultant, Divisional Director, Clinical Lead or nominated deputy must be informed immediately that appropriate clearance has not been received. He/she will then be required to asses the risk and make the decision as to whether or not to accept the locum and allow them to perform exposure prone procedures during the course of the locum appointment. 3. New appointees to the Trust 3.1 All new employees to the Trust whose work is likely to involve participation in exposure-prone procedures will be required to provide to the Occupational Health Department prior to their date of appointment proof of their BBV status in line with current Department of Health guidelines. 3.2 New appointees will not be passed fit for employment until satisfactory proof of BBV status (where needed) has been demonstrated. Where this proof is not available prior to or on their first day of employment and the relevant manager cannot wait for this status to be received, the individual concerned and their manager will be instructed by the Occupational Health Department that they are unable to participate in exposure-prone procedures until confirmation of their BBV status is received by the Occupational Health Department. 4. Medical Students and Academic Visitors 4.1 Medical Students will be unable to participate in exposure prone procedures until they have been immunised and any failure to respond to vaccine has been adequately investigated or they have demonstrated satisfactory proof of Hepatitis B status 4.2 Any visiting health professionals within the Trust who will be responsible for the care of Trust patients will be required to provide proof of their BBV status before they are able to participate in exposure prone procedures. It is the Employment policy on protection against infection with blood-borne viruses v4 9

10 responsibility of the relevant Consultant to ensure that this is complied with in such circumstances. 5. Retraining 5.1 Any employee of the Trust who is found to be a carrier of a Blood Borne Virus will be required to cease exposure prone procedures immediately. 5.2 The relevant Divisional Manager/ Director in conjunction with the Occupational Health Physician and the Director of Health Development and Modernisation will be responsible for giving fair and objective consideration to the options available. 5.3 Initially, the possibility of the employee remaining in their current job will be carefully considered. Where this is not deemed appropriate, temporary redeployment will be considered so that treatment (when available) to reverse the carrier status can be tried. If permanent redeployment becomes necessary, this will involve giving consideration to a move to a post which does not involve exposure prone procedures. 5.4 Where alternative employment is not readily available, appropriate advice and guidance on retraining/alternative employment will be taken from, for example, the Postgraduate Dean for medical and dental training grades and local senior professional staff for nurses and midwives. 6. Compensation 6.1 Hepatitis B and hepatitis C are prescribed industrial diseases for health care workers and employees may be eligible to claim Industrial Injuries Disablement Benefit. Where appropriate, the Trust will provide assistance to employees in making such a claim. 7. Refusal to comply 7.1 Where employees refuse to provide proof of their BBV status the Trust will manage them as though they were an infectious carrier and will seek legal advice regarding its responsibility for retraining and redeploying such staff. 7.2 All employees who are at risk of contracting Hepatitis B have a duty of care to themselves and patients and are therefore advised to protect themselves through a Hepatitis B vaccination programme. Those who decline will be made aware of the risks of contracting Hepatitis B through their employment by the Occupational Health Department. Employment policy on protection against infection with blood-borne viruses v4 10