THE ABRAMS REPORT - COMMUNICABLE DISEASE-CONTROL - HOW DO HEALTH DISTRICTS MEASURE UP TO THE RECOMMENDATIONS

Background The aims of the study were to examine whether Health Distri cts in the North Western Region complied with the recommendations in t he Abrams report regarding the control of communicable disease [incorp orated into the Annex to Circular HSG(93)56], and to identify areas th at need further attention. Methods The recommendations were extracted and arranged in questionnaire form. Further items were included dealin g with the use of Epinet in communicating with the profession. A compl iance score was derived from affirmative and qualified affirmative res ponses. Results Many recommendations were met by all or most Districts . Compliance was 90 per cent or over for 58 per cent of the questions where an assessment was appropriate. Of the 16 Districts in consortia, 75 per cent did not have a consortium plan. Day-to-day plans were inf ormal in 21 per cent of Districts; In 63 per cent of Districts the Fam ily Health Services Authority (FHSA) was nor involved to the extent th at it should be, The Consultant in Communicable Disease Control (CCDC) had insufficient District Health Authority support in 42 per cent of Districts and insufficient Local Authority support in 16 per cent of D istricts, In 58 per cent of Districts there was lack of inclusion of m atters relating to the control of infectious disease in contractual st atements between purchaser and provider. There was a lack of audit in 47 per cent of Districts. Conclusions One plan or a compatible series of plans are required across each District; Informal day-to-day plans should be formalized. The FHSA should be fully involved in infectious disease control plans. Certain Districts require;a Community Infection Control Nurse, accountable to the CCDC and/or administrative support to input and scan surveillance data. Contractual statements between pu rchaser and provider should include appropriate infection control requ irements when this is not already the case. Communicable disease contr ol audit should be a regular part of CCDC duties.