North Yorkshire Council
Health and Adult Services
Executive Member Meeting
3 November 2023
REPORT TO Director of Public Health in consultation with the Corporate Director and
Executive Member for Health and Adult Services
Infection Prevention and Control (IPC) Service
This report includes a supporting Annex which contains exempt information as described in paragraph 3 of Part 1 of Schedule 12A to the Local Government Act 1972 (as amended).
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1.0 Purpose Of Report
To seek approval for the development of a new contract and legal framework for the community Infection Prevention and Control (IPC) Service.
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2.0 Background
The current community Infection Prevention and Control (IPC) service has been operational in North Yorkshire and York for over a decade. Since the responsibility for Public Health under the Director of Public Health moved from the NHS to local authorities, North Yorkshire Council (NYC), City of York Council (CoY), North Yorkshire and West Yorkshire ICBs (previously North Yorkshire, Vale of York, and Airedale Wharfedale Craven CCGs) have commissioned Harrogate District Foundation Trust (HDFT) to deliver the community IPC service, along with the community TB service. Prior to the COVID-19 pandemic, the commissioners began a review of the service specifications for the IPC and TB contracts; however, due to the pandemic the updated specifications were never ratified.
Partners have recently regrouped to proceed with a review of the IPC service in particular, in light of the lessons learned around local IPC needs from the pandemic. NYC has held joint discussions with the other service commissioners (CYC, HNY and WY ICBs) and agreed to undertake an options appraisal for the future commissioning of the services. The full options appraisal is included in the exempt section of this report.
Current provision
The North Yorkshire and York Community Infection Prevention and Control (NYY CIPC) service is hosted by, and is an integral part of, the Harrogate and District NHS Foundation Trust (HDFT) Infection Prevention and Control Service.
The NYY CIPC service provides advisory, responsive, investigative and educational Infection Prevention and Control (IPC) support for North Yorkshire and York (NYY) providers of health and social care in the community. This is achieved through collaboration and a structured proactive programme to actively promote strategies to raise awareness of infection prevention and control based on national requirements, best practice and local need. Where necessary the service provides a responsive service to any peaks in activity as a result of local outbreaks of infection.
The NYY CIPC Service contributes to a continuous reduction in the burden of infectious disease, including healthcare associated infection (HCAI), in all NYY Community Health and Social Care settings.
With regards to assurance, the service provides quarterly and annual reports covering surveillance, incidence and trends, Root Cause Analyses (RCAs), services (including target IPC visits, audits and training) and progress against the CIPC Annual Plan.
3.0 Issues
The contract and the service specification under which the service operates needs reviewing and updating.
The current service is predominantly focused on adult care homes; the pandemic has highlighted the need for IPC support to a wider range of settings including special schools, contingency accommodation settings, public health commissioned services and others. More flexibility is needed to manage urgent issues outside the standard remit of the service and to increase the focus on prevention.
4.0 Alternative Options considered
The alternative to proceeding with the development of a new contract and legal framework for the community Infection Prevention and Control (IPC) Service would be to carry on without change to existing arrangements, or doing a light-touch review of the service specification. However, neither of these options would be sufficient to address all the issues identified above.
5.0 Financial Implications
No additional financial costs to develop a new contract and legal framework for the community Infection Prevention and Control (IPC) Service have been identified at this stage.
6.0 Legal Implications
Legal colleagues have already been engaged in early work identifying the need for review and discussion of potential options for legal frameworks for the IPC service. There will be some continued commitment required from legal, although the amount of input will depend on the legal framework chosen.
7.0 Contribution to Council priorities
This work is likely to contribute towards the following priorities:
People can access good public health services and social care across our different communities
· To support and develop care providers, improving sustainability and quality.
· To work with a range of organisations from the health, independent and voluntary sectors to develop a sustainable, diverse and innovative care market that meets the varied needs of the people of North Yorkshire and ensures quality and dignity for all.
· To work with the NHS to develop integrated models of commissioning and service delivery in each area of North Yorkshire to ensure that the people of North Yorkshire have a cost efficient, effective and joined up health and social care provision.
8.0 Risk Management Implications
There is a risk that by not undertaking a review of the current IPC service delivery the system will be inadequately prepared for future pandemics or other issues or outbreaks requiring a robust community IPC response.
9.0 Human Resources Implications
Additional staff time will be required to support the contract review. Project management support has been agreed along with public health capacity.
10.0 Equalities Implications
An equalities impact assessment will be undertaken as part of the development of the new contract and legal framework.
11.0 Climate change implications
A climate impact assessment will be undertaken as part of the development of the new contract and legal framework.
12.0 Reasons for recommendation
· Commissioning partners are universally supportive of the need to undertake the development work for a new IPC contract and legal framework due to the issues outlined above and the lessons learned from the pandemic around community IPC requirements in North Yorkshire and ensure resilience for to deal with future health protection issues.
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13.0 Recommendation · Approval to proceed with development of a new contract and legal framework for the community Infection Prevention and Control (IPC) Service
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Name and title of report author
Dr Victoria Turner, Public Health Consultant