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Hi Sue I'm in a very similar situation, having set up a new OH service, when prior to my arrival all there was for HCWs hep B results and I don't have all of them. For new starters, I ask for the 'works' as in the Bible (Chapter 12, Green Book). Not an opportune time for Refuseniks as they think they won't get a Health Clearance for the job if they don't comply. I'm doing a retrospective round up now. A good PR exercise is if your staff have any in-house training sessions, or Team Briefs, get your name down, book a session and present - don't need to tell you the rationale and what to say. I emailed each staff member individually working on one geographical region at a time. If I knew a person didn't do email I posted a form. I did 3 reminders in the first region. I was very keen then. Then two I think in the next. Probably will leave it at one reminder now. There is far from a 100% response rate, but there's only so many hours in the day that can be allocated to this unless you have good admin support or can delegate to another team member. Not sure how much good this advice will be helpful in an unwilling workforce. Good Luck Carolynne Davey Occupational Health Advisor SSAFA Forces Help HQ BFG HS Wegberg BFPO 40 Tel: 0049 2161 908 2481 Military (948) 67 2481 _____ From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of sue harrison-stone Sent: 24 June 2008 16:41 To: [log in to unmask] Subject: Re: [OCC-HEALTH] Measles immunity assessment Dear All I am sorry to come back to immunisation but I need some advice. Because our OH records were so poor, i.e. no notes at all, not filling in the immunisation record sheet, staff not knowing if or what they had been immunised against etc etc we were instructed by he Infection Control committee to send out a questionnaire to every employee in the Trust to gather immunisation details. Given the number of folk employed we have had a very poor response both in numbers and information including don't know, or got vaccinated years ago and cant remember or look in my notes! Prior to sending out this form I put an article in the Trust magazine so folk knew it was coming. We then did a simple form and included on the form a section for those refusing to give the details. We did a cover letter to explain what we need and why. We also sent a letter to every manager asking for their help to list their staff and tick who had or had not returned the form. We said anyone could return the form direct to us if they did not want their manager to see the completed form. We asked the manager to say what risk level, made it simple, high, medium or low each person was at re their job. All of this was done with the knowledge and approval including contents of form and letters of HR. Well that is where the .... hit the fan! If we set aside the employees it is the managers that I am having most problem with. They are saying that this is medically confidential details, they wont hand out the forms, and they don't know the risk to their teams of exposure and it seems that they don't think they need to. They are demanding meetings with the Board downwards and are generally refusing to co operate. This is despite the fact they are supposed to start getting all this info at interview along with all the rest of stuff we all take to interviews like pin cards etc. To my mind managers should know the hazard, risk and controls to protect their staff. I would not have classed vaccination history as confidential medical details, its a bit like prevention and management of aggression training and is put in place for staff protection. Surely they would expect to know that their staff were protected from physical assault whether it is being hit or or protected from infection. One from vaccines the other from training. Any suggestions please? regards Sue _____ Date: Thu, 19 Jun 2008 13:03:13 +0100 From: [log in to unmask] Subject: Re: [OCC-HEALTH] Measles immunity assessment To: [log in to unmask] Dear all, we obtain immunity through testing for measles and rubella in addition to varicella rather than blanket MMR vaccination. The cost issue is balanced between the cost of 2 appointments for MMR versus the test cost of the measles/rubella serology. MMR requires the employee to be away from the place of work on 2 occasions and takes up 2 clinic appointments and admin support time. All these have costs associated with them. On the plus side is that you will not have to pay for the vaccines. Serology requires one appointment for the employee and one clinic slot and also admin time to process results and the vast majority of employees (typically 95% or more based on our own experience) will be immune against both measles and rubella and so very few. We are just about to implement a policy of compulsory screening/ immunisation of all new clinical staff which will be included in their terms of employment. In specific areas those without the required evidence of immunity or those declining screened will be refused employment due to the risk to patients. Naturally there will be a minority of individual circumstances where we may have to make exceptions but this will be on a case by case basis. we are also performing catch up screening for existing clinical staff although this will not be in the terms of employment at this stage. Clinical staff have a duty of care to their patients and may be professionally negligent if they fail to comply with immunisation/ screening requirements. regards Paul D'Arcy Clinical Nurse Leader Workplace Health & Wellbeing Hammersmith, Charing Cross and Queen Charlotte and Chelsea Hospitals Imperial College Healthcare NHS Trust Tel 020 8846 1137 Facsimile 020 8846 1160 Paul _____ From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of Davey, Carolynne Ms Sent: 19 June 2008 12:32 To: [log in to unmask] Subject: [OCC-HEALTH] Measles immunity assessment I also started a new in-house service, approx 2 yrs ago, and I now check new starters as per Chapter 12 Green Book. For staff who did not get fully screened I am trying to do a retrospective catch up as well as taking advantage of when staff transfer posts and need a further health clearance. Hope this helps Carolynne Davey Occupational Health Advisor SSAFA Forces Help HQ BFG HS Wegberg BFPO 40 Tel: 0049 2161 908 2481 Military (948) 67 2481 _____ From: [log in to unmask] [mailto:[log in to unmask]] On Behalf Of sandy Sent: 18 June 2008 22:15 To: [log in to unmask] Subject: [OCC-HEALTH] Measles immunity assessment I work in the NHS for a Mental Health Trust. I have now been in post for 12 months developing a new in house service. Following a recent DoH communication re doctor spreading measles-it has been questioned whether checking of staff for measles should be undertaken. I am aware that the "Green Book " has recommendations. I wondered if colleagues would share how they have managed the measles, mumps, rubella, varicella situation in such an environment? -Do you routinely check all new starters? If so for all 4 diseases or just some? -Do you take short cuts e.g. assume mothers have been assessed during pregnancy for rubella? -The thought seems to be going towards giving MMRx2 to all permanent staff on certain in-patient areas as the vaccine is free and serology costs. Proof of previous immunisation will naturally preclude this. How do you manage the fact that staff do bank shifts? in the selected areas? Also locum medical staff, OTs, psychologists etc? -Do you check community staff? -Do you have much success in obtaining written proof of MMR X2 vaccination history? I seem to struggle. Looking forward to your replies Sandy ~~~~~~~~~~~~~~~ Please remove this footer before replying. 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