To receive apologies for absence.

Apologies were received from Councillors Mrs W.U. Attfield, Ms G.A. Powell and J.B. Williams.

To receive details of any Member nominated to attend the meeting in place of a Member of the Committee.

There were no named substitutes.

To receive any declarations of interest by Members in respect of items on this agenda.

There were no declarations of interest.

To approve and sign the Minutes of the meeting held on 23rd June, 2004.

The Committee deferred consideration of the accuracy of the Minutes of the meeting held on 23rd June, 2004.

To review how the outbreak of legionnaires disease in Hereford City was managed.

The Committee began its review of how the outbreak of legionnaires disease in Hereford City in October 2004 had been managed.

The following people had been invited to provide information to the Committee:

·         Dr Mike Deakin                         Director of Public Health – Herefordshire

·         Dr David Kirrage Health Protection Agency - Hereford and Worcester Local Health Protection Unit

·         Mrs Lynne Kedward Hereford Hospitals NHS Trust - Acting Director of Nursing at the time of the outbreak and now Project Director – Emergency Services Redesign

·         Mr Paul Nicholas Herefordshire Council - Environmental Health Manager (Commercial)

·         Mr Andrew Tector Herefordshire Council - Head of Environmental Health and Trading Standards

Each invitee had provided a written submission in advance, which had been circulated, to Members of the Committee.

The Committee had also received a letter from Mr Paul Bates, the Chief Executive of the Herefordshire Primary Care Trust, reflecting on his personal experience as a Chief Executive tackling his first major public health challenge.

Dr Ian Tait General Practitioner and Chairman of the Primary Care Trust’s Professional Executive Committee had also written about the communication of information to GPs during the outbreak.

Mr Neil Pringle, Chief Executive of Herefordshire Council, was also present to advise the Committee and comment on his own involvement in managing the outbreak.

Ms Ann Fleming, recently appointed Communications Manager for the West Midlands Region of the Health Protection Agency was also present.

The Chairman explained that the Committee’s intention in conducting its review was to focus on the logistics of the outbreak, the lessons learned, and to establish the readiness to deal with a similar or potentially more serious event in the future.

Statement by Dr Kirrage

Dr Kirrage gave a presentation on the chronology of the outbreak broken down into five stages: identification and investigation of first confirmed cases; formation of the Outbreak Control Team; the restructuring of the Outbreak Control Team; the running of the investigation; and the debriefing after the outbreak was over.  He identified lessons learned at each stage and the outcomes and key messages.

The lessons learned included:

·         Outbreaks can become big very quickly and result in extensive media coverage.

·         Demand for media coverage will impede the investigation unless media support is available.

·         Such situations will generate a high level of political interest.

·         The respective responsibilities of the Health Protection Agency and the Primary Care Trust had initially been uncertain although this had been very quickly resolved.

·         There had been issues about protecting patient confidentiality particularly from the national press.

·         The separation of the strategic management of the incident from the investigation and management of the outbreak had worked well.

·         Experienced media support was essential.

·         The economic impact could influence the respective responses of the Local Authority and the Primary Care Trust.

·         There had been very good working relationships within the Outbreak Control Team.

·         The investigation could be left to the outbreak control team but there was a need to be aware of the effect on other Primary Care Trust Staff and keep them fully  ...  view the full minutes text for item 13.