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The Health and Social Care Act 2008 - use of contractors
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Posted By Malcolm Greenhouse The above act puts a duty on an NHS type client to ensure that contractors used in social care / health situation are made aware of the risks from infectious diseases and are given information to help lower the risk of infection to themselves and others. My trust has suggested that the issuing of a signed for information leaflet is sufficient.
Anyone any comments, any health care organisations following a different route to compliance? Do any health care establishments have contractor induction courses?
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Posted By Ron Hunter Could you confirm the Section of the Act that requires this?
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Posted By martinw Malcolm, it also depends on what the contractors are doing and where they are doing it. Information is always supplied, but each ward, area, department will have instructions and risk assessments for control of contractors - it is obviously higher risk in say barrier wards that in general wards - and the way some trusts manage this is geographical. By this I mean that as with most safe systems of work, the contractors will be allowed in particular areas with particular controls for that work and area depending on risk - within this it would be ensured that the correct PPE would be required also. In other words, contractors are not free to just wander around - strict controls are in place not just for infection control, but also for patient privacy and confidentiality. The estates department or similar may be the ones to approach for your Trust's specific policies.
Martin
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Posted By Ron Hunter As I read the Act and the Section referred to, it says that the "Secretary of State may make Regulations as he thinks fit for the purposes of" (inter alia) the issue you refer to.
The question then surely is whether the SoS has used these powers to produce any such Regulations?
You can't comply with a statute that doesn't exist?
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Posted By Robert K Lewis We should always remeber though that if the contractors are undertaking construction work as defined in CDM 2007 than there is an absolute requirement on the client (Trust) to provide relevant information to the contractor. This would include the specific risks of infection in the areas where work will be undertaken. If this has to be done for construction work then of course it would be good practice to issue the same information to all contractors.
A simple generic leaflet will not satisfy the needs for construction contractors even if the Trust decides it is adequate for other contractors. The ultimate answer will come in the courts when it will be the Management regs and HASAWA that will determine what should have been done with regard to information provision. The idea of a leaflet seems a trifle de minimus to me!
Bob
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Posted By Raymond Rapp Must agree with Bob on this one. Providing a leaflet with a signature seems like nothing more than a back covering exercise. I think it was brought to court that the judge would see right through it too.
Other interventions could include a pre-start meeting with contractors, site induction and/or PowerPoint presentation.
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Posted By Malcolm Greenhouse Thanks to all those who have responded. I am currently not working in a safety role but that of estates officer in the NHS. I work in local services which involves several small units spread out over a 250 square miles. The contractors used vary from plumbers to electricians to floor layers to general handymen. I was busy looking at how we met our commitment as clients under the management regulations to supply information about hazards when infection control asked the question about complying with the Health and Social Care Act which basically says the same thing re the sharing of information. I had already come to the conclusion that the paper based mechanism we had was not really effective in ensuring that contractors were aware of the hazards but on site induction will be difficult because of number and size of locations.
Starting to think that we will have to drastically reduce the number of contractors we use and insist on some basic NHS specific hazard training. Covering such issues as Legionella, Ligature risk (not creating them)infection control and service user risks (mental health trust).Any one know of any safety passport schemes that might have the ability to include a module of NHS specific risks?
Any NHS people out there who currently provide training to their contractors in this area?
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Posted By Robert K Lewis Malcolm
THe contractors you mention are essentially construction and CDM applies with the attendant requirement for information. Training will assist but only as part of the system
Bob
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Posted By Malcolm Greenhouse Bob
My understanding of CDM is that apart from the notification requirements CDM regulations apply to all construction jobs irrespective of duration. However the tasks that these contractors are employed on are all minor works type jobs of 1 hour to three days duration.Consequentially other manager within the function do not think that the same principles apply.
As I see it if we use the same core of contractors then we could run a cost effective training/induction session with them but there is a reluctance to reduce the ability to test the market on a regular basis by employing new contractors.
Perhaps I should spread the net wider in search of a benchmark solution. What do other organisations with multiple sites with no facilities management present do to control contractors performing small tasks on those sites?
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Posted By Robert K Lewis Malcolm
Agreed but as yopu rightly say the work is still construction work as defined in the regulations and the duration of the task is of no account. Part 2 contains the requirements for information provision among other things and this cannot be avoided as this section applies to all construction work. Your underlying problem is that you have managers still locked into thinking derived from the 94 regulations. In your position I would clearly state the position in writing and let the senior management take the responsibility if that is what they wish to do. I only hope that no consequences arise. If any do then the Trust is likely to find itself in a difficult position.
Bob
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Posted By DJ Malcolm, I think you may have got the wrong end of the stick in respect of this provision. s.20 of the Health and Social Care Act 2008 only applies to "Regulated Activities" under s. 8. The Health and Social Care act 2008 (Registration and Regulated Activities) Regulations 2009 provide at Regulation 3 that, Regulated Activities are those involving the provision of healthcare to patients, ambulance services and the management of blood and tissue by NHS Blood and Transplant. This provision has nothing to do with providing information to e.g. building contractors. Please feel free to email me at@ djupnorth@hotmail.co.uk if you wish to discuss the Act or regulations in more detail. Best regards. DJ
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Posted By Ron Hunter And the Act is an "enabling" one. The SoS has to have made Regulations to cover the issue.
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Posted By Malcolm Greenhouse
I have cut and pasted the following from the Code of Practice for NHS on the prevention and control of healthcare associated infections and related guidance from the Department of Health.
It defines what a healthcare worker is and clearly includes engineers, see aster ix.
Also in part (d) contractors are clearly indicated as requiring training.
"Healthcare workers
Guidance for implementation of compliance criterion 9 Ensure, so far as is reasonably practicable, that healthcare workers are free of and are protected from exposure to communicable infections during the course of their work, and that all staff are suitably educated in the prevention and control of HCAI. A healthcare worker* is any person whose normal duties concern the provision of treatment, accommodation or related services to patients and who has access to patients in the normal course of their work. This term includes not only front-line clinical and paraclinical staff, but also some staff employed in estates and facilities management, such as cleaning staff and engineers. Providers should ensure that policies and procedures are in place in relation to the prevention and control of HCAI such that: a. all staff can access relevant occupational health services; b. occupational health policies on the prevention and management of communicable diseases in healthcare workers, including immunisation, are in place; c. prevention and control of infection is included in induction programmes for new staff, and in training programmes for all staff; d. there is a programme of ongoing education for existing staff (including support staff, agency/locum staff and staff employed by contractors); e. there is a record of relevant immunisations; f. there is a record of training and updates for all staff; and g. the responsibilities of each member of staff for the prevention and control of infection is reflected in their job description and in any personal development plan or appraisal."
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