I think the reason for assessing the TB status of staff at the
pre-employment stage is to assess their fitness to work. Whether they have
had the BCG or not would not affect their ability to start their work and
therefore is not a pre-employment issue.
Assessing the potential infection risk of a new member of staff is a
pre-employment issue. I think this can be picked up though the health
questionnaire asking whether they have had TB symptoms in the last year.
Staff arriving from High prevalence TB countries in the last 5 years should
be seen or poof of status supplied at the pre-employment stage.
The assessing of BCG status and offering of the vaccine can be offered after
they have started work. Of course the BCG can only be offered to new staff
and is not compulsory as far as I am aware, however I believe that the
offering of the vaccine is good practice and should be carried out by OH
dept.
Any more thoughts are welcome
-----Original Message-----
From: Porter Suzanne [SMTP:[log in to unmask]]
Sent: 08 December 2003 09:31
To: [log in to unmask]
Subject: Re: BCG DEBATE
Hi
I have to confess that we only see new staff who will have patient
contact
or who need health surveillance etc. So any staff member who is
working in
admin for example will not be seen anyway unless they are
potentially at
some risk. Like you we tend to see most new starters after they have
started
and we try to see them within 2 weeks of start date. The only
exception are
the new doctors who are brought down to us on their first day for
clearance.
We also saw our overseas recruits on their first day. Ideally we
would see
all new staff and we would see them before they start but workload
and the
recruitment process would not allow for this.
I do worry that some must fall through the net though. Additionally
we tried
to set up Heaf sessions in order not to waste PPD, but people
inevitably
fail to attend the appt. We are having to revert to testing at
initial appt
and bear the cost of the wastage.
Regards
Su
-----Original Message-----
From: Saghir Siraj [mailto:[log in to unmask]]
Sent: 05 December 2003 12:02
To: [log in to unmask]
Subject: Re: BCG DEBATE
To change the subject a little could I ask what are peoples opinions
on TB
and health clearance for the NHS health care worker.
At the moment we clear staff to start work and then check their TB
status
after they have started. This is due to the practicalities of
checking
scars pre-employment. The only exception is those staff coming from
countries with high incidence of TB.
The issues I am looking at are as follows:
1 Should all clinical staff be checked for scar or heaf test(if no
scar)
pre-employment.
2 Are TB symptom questions on the pre-employment questionnaire
adequate for
clearance if no abnormalities stated.
3 Is it or should it be compulsory for all new staff to physically
attend
the OH for scar check if they do not have documentary proof.
Unlike Hep B/C status for EPIP workers which is unambiguous, I find
that TB
clearance is difficult to nail down and do not find the DOH document
"HEALTH
CLEARANCE FOR SERIUS COMMUNICABLE DISEASES" althogether clear, it
states
that "ALL NEW ENTRANTS TO THE NHS" should be checked for TB status.
I would
be interested to know what happens in other departments.
All opinions welcome.
Saghir
-----Original Message-----
From: Baldwin Chris (RFF) Occupational Health Nurse
Advisor
[SMTP:[log in to unmask]]
Sent: 05 December 2003 10:48
To: [log in to unmask]
Subject: BCG DEBATE
Good morning everyone,
thank you all for your fascinating responses and comments
etc re
this
original question.
As a newish subscriber and also OH degree student, I seem to
have
set
everyone off with discussion and debate. The original
question was
posed as
a result of a colleague in another part of the country
expressing
some
concern re vaccination and Heaf testing partly due to
confidence in
the
correct technique even with training and also Heaf testing,
subsequent BCG's
etc taking into account past history, proof of vaccination,
guidelines etc
and a toe was placed in the water to gain some insight into
fellow
OH
professionals feelings and practice also on this issue. This
forum
in terms
of information gathering and learning resources is priceless
and
thank you
all for your sharing of knowledge and experience and details
of same
have
been passed on to my fellow class mates. May I come out from
under
the table
now please?
Best wishes to you all for Christmas
Chris Baldwin
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