Health Protection

What is Health Protection?

Health protection is one of the domains of public health work (the other two being health improvement and public health healthcare).   Health protection practitioners work to protect individuals, groups and populations from cases or outbreaks of infectious diseases and incidents of non-infectious environmental hazards (e.g. chemicals and radiation).  This is largely a responsive service, managing outbreaks and situations (e.g. COVID-19, measles) but health protection services also monitor emergence of diseases in the population, observe effect of immunisation on different diseases, provide support for training of healthcare professionals and tackle antibiotic resistance and hospital acquired infections.  

In England, a Health Protection Team (HPT) is a multidisciplinary team consisting of, nurses, practitioners, doctors, surveillance and administrative staff who work closely with colleagues in PHE, environmental health departments, hospital microbiologists and infection and prevention control teams, GPs, community specialists and educational institutions.  There are a number of these teams across the country, looking after their locality.  Every HPT has an on-call service which provides support to healthcare professionals and members of the public and responds to notifications of infectious disease and any health protection needs.  Nationally, there are functions for strategic health protection work and emergency planning. 

Health Protection Areas of Work

• Communicable disease control
• Environmental health
• Chemical hazards and radiation
• Emergency Preparedness, Resilience and Response (EPRR)

Essential Principles of Health Protection

1. Planning and preparedness
2. Prevention and early detection
3. Investigation and control
4. Wider public health management and leadership 

These principles apply to all circumstances whether dealing with issues, cases, outbreaks or incidents.  The 4th principle on leadership revolves around reflection.  This involves reflecting on what happened in certain cases, incidences or outbreaks, pulling together the lessons learned with the science and the ways of doing things.  This can then be used for continuing professional development  and improved ways of working going forward.  It also includes the communication of these learnings to health professionals, other stakeholders and the public. 

See chapter 3 of Health Protection: Practice and Principles for more information. 

Communicable Disease Control

The day to day job consists of dealing with enquires about communicable diseases, identifying cases (case finding), contact tracing, preventing onward transmission and managing or controlling situations (settings where there are clusters or outbreaks).  Contract tracing can contain enhanced or backward contract tracing, i.e. movements in the period prior to symptoms being developed to identify sources of infection.  This is commonly used for sexually transmitted infections.  

Information gathered is collated into surveillance.   For example, for notifiable infectious diseases, registered medical practitioners in England and Wales have a statutory duty to notify their local authority or local Health Protection Team of suspected cases of certain infectious diseases. All laboratories in England performing a primary diagnostic role must notify Public Health England (PHE) when they confirm a notifiable organism. PHE collects these notifications and publishes analyses of local and national trends every week.

Emergency Preparedness, Resilience and Response (EPRR)  

Public health emergency preparedness, resilience and response (EPRR) involves activities directed at preventing possible incidents and emergencies that could affect a population and planning to ensure an adequate response and recovery if an emergency occurs.  This includes planning for extreme weather conditions, epidemics of  infectious diseases, major transport accidents, water or energy shortages or terrorist attacks.  A combination of public agencies will work together on EPRR.  Different public organisations will have their EPRR departments, for example, there are EPRR teams in Public Health England and in NHS England & Improvement.  Local authorities (councils) have emergency planning officers.  In NHS, EPRR teams will be involved in winter planning, such as trying to reduce the pressures on hospitals and community services during winter due to respiratory illnesses like 'flu and RSV.  They will also have plans for avian flu and other potential pandemics.  Emergency planning officers in local authorities will be involved in cold weather and heatwave planning and local business contingency planning.  In PHE,  EPRR provide public health  advice to internal and external stakeholders in the areas of emergency preparedness, resilience and response.  

EPRR teams aggregate and analyze information from across the public health and health system to inform early event detection and situational awareness.  They also provide guidelines and updates.  There are five phases to emergency management: prevention, mitigation, preparedness, response and recovery.  Emergency planning is a cyclic process  - design and develop, train, exercise,  review and amend plans/approaches to emergency health incidents.