Table 2 Phased approach to respond to local variation in CD vs. NCD outcome variations
Health Protection guidelines [12] | Area of response | Proposed Noncommunicable Disease guidelines |
|---|---|---|
“Initial investigation to clarify the nature of the outbreak [refer to Table 1] begun within 24 h Immediate risk assessment undertaken and recorded following receipt of initial information” | Incident recognition | Use routinely collected data for surveillance and early recognition of change in outcomes. Investigate potential incident of sustained or step change with possible single cause or focus of variation |
“Decision made and recorded at the end of the initial investigation regarding outbreak declaration and convening of Outbreak Control Team (OCT)” | Incident declaration | Decision made and recorded at the end of the initial investigation regarding incident declaration and convening of Incident Control Team (ICT) from appropriate partner organisations |
“Outbreak Control Team held as soon as possible and within three working days of decision to convene all agencies/disciplines involved in investigation and control represented at OCT meeting” “Roles and responsibilities of OCT members agreed and recorded” “Lead organisation with accountability for outbreak management agreed and recorded” | Incident Control Team | ICT held as soon as possible and within ten working days of decision to convene all agencies/disciplines involved in investigation and control represented at ICT meeting Roles and responsibilities of ICT members agreed and recorded Lead organisation with accountability for incident management agreed and recorded |
“Control measures documented with clear timescales for implementation and responsibility” “Case definition agreed and recorded” “Descriptive epidemiology undertaken and reviewed at OCT. To include: number of cases in line with case definition; epidemic curve; description of key characteristics including gender, geographic spread, pertinent risk factors; severity; hypothesis generated” “Review risk assessment in light of evidence gathered” “Analytical study considered and rationale for decision recorded” “Investigation protocol prepared if an analytical study is undertaken” | Incident investigation and control | Urgent control measures indicated from initial investigation agreed and implemented Outcome deterioration definition agreed and additional data to support investigation sourced from ICT members/partner organisations. Descriptive epidemiology of routine and additional data undertaken and reviewed at ICT to aid hypothesis generation. To include: outcome trend over time; description of key characteristics of cases including age, sex, access to health care, pertinent risk factors (e.g. late stage cancer diagnosis);severity (e.g. estimated impact on mortality); Review/implement control measures and public health interventions in light of evidence gathered Analytical study considered and investigation protocol prepared if an analytical study is undertaken Agree defined markers of point where control has been re-established |
“Communications strategy agreed at first OCT meeting and reviewed throughout the investigation” “Absolute clarity about the outbreak lead at all times with appropriate handover consistent with handover standards” | Communications | Communications strategy agreed at first ICT meeting and reviewed throughout the investigation. Absolute clarity about the lead organisation at all times and point of closure of incident |
“Final outbreak report completed within 12 weeks of the formal closure of the outbreak” “Report recommendations and lessons learnt reviewed within 12 months after formal closure of the outbreak” | End of Incident | Final outbreak report completed within 12 weeks of the formal closure of the incident Report recommendations and lessons learnt reviewed within 12 months after formal closure of the incident |