The IMO has reached agreement with the HSE on a comprehensive scheme to enable the screening of health care staff involved in exposure prone procedures for Hepatitis B and Hepatitis C immune status and the immunisation of those who are not already immune.

The scheme also provides for a wide range of protections for staff who contract viruses at work including provision for retraining, redeployment and compensation as well as an independent appeals process to deal with any disputes.

Full details of the scheme are available on request from IMO House.

• As of  lst May 2008, all staff starting a new post in the health services for the first time where they might be required to be involved in an exposure prone procedure will have to provide evidence via the Occupational Health Service that they were immune to and not infectious for Hepatitis B.   Unless such a statement exists a potential member of staff will not be employed in a post which would include EPPs.

Screening

The IMO has long sought the introduction of such a scheme and recent discussions have also taken into account a Department of Health and Children report of March 2006, which imposed a clear responsibility on healthcare providers to protect staff and patients from cross infection arising from blood borne virus.

The fact that agreement has been reached means that the IMO can now advise members to co-operate with requests for testing of their immune status.  Importantly, it has also been recognised that NCHDs need only submit for testing on one occasion and need not provide evidence on each subsequent rotation to other hospitals while they continue to work in Ireland.

Support

A confidential helpline will be developed to provide basic information and contact details in the event of exposure. Procedures will be put in place to ensure direct and quick access for those who require advice or treatment following contact with risk material.  The agreement provides for reasonable accommodation involving retraining and redeployment if an individual cannot be accommodated in their present post. Employing authorities will be required to make every effort to redeploy an infected healthcare worker within the same organisation where that is the most appropriate course of action for the employee.

Any changes that alter the job description or clinical practice of an infected worker must be agreed with the employee concerned. If a dispute arises with regard to such a change a National Advisory Panel involving union representatives will deal with the dispute. Where necessary, a National Training Body will be required to ensure additional places to accommodate infected workers who, early in their career, are required to change paths.

All efforts under the agreement must be made to retain the person in full employment with the necessary supports.

Where a staff member is diagnosed as being infected with hepatitis B and medical evidence indicates they are required to curtail their practice and are unavailable for work, the individual concerned will receive full pay inclusive of premiums and allowances for a period of six months. In an important breakthrough, the IMO secured recognition that the payment would also take account of overtime payments which would otherwise fall to be paid to NCHDs.

This will not affect their normal entitlement under the sick pay scheme and will be subject to the employee co-operating with reasonable procedures to assist their recovery or retraining.

If at the end of six months the staff member is unlikely to return to work but there remains a reasonable expectation that they may at some future date be able to do so, an extension of pay under the scheme for a further three-month period may be allowed. Such extensions can be continued up to a maximum of 12 months.

In exceptional circumstances at the expiry of the special pay arrangements Article 109 of the Superannuation Scheme may be invoked which provide for enhanced benefits under that scheme for those injured at work.

Any costs arising from infection that is obtained through occupational hazard in the public health service will be borne by the individual employer and general practitioner, casualty and consultant visits and prescriptions charges, where they are incurred, will also be reimbursed by the employer.

Clear Guidelines

The view of the IMO and other unions involved in negotiating the terms of the scheme - the Irish Nurses Organisation, Irish Hospital Consultant Associations and the Irish Dental Association - is that the need to protect patients and staff from cross infection had to be addressed and at the same time procedures that effectively deal with injuries such as needle stick needed to be clarified and put in place.

This agreement, which can be reviewed after 12 months of its operation, is the first attempt by the Irish public health service to put in place clear unambiguous guidelines which can assure staff that a humane accommodating approach will be taken in the unfortunate event that they are unable to achieve immune status or that they acquire a blood borne virus.

• As of  lst May 2008, all staff starting in a new post in the health services for the first time (either in a training or career post) should be tested for Hepatitis C, if their post involves EPPs. Typically, but not exclusively, this would include the following specialities:
  • Surgery
  • Obstetrics & Gynaecology
  • Midwifery.
  • Nursing involving EPPs (e.g. Theatres)
  • Dentistry
  • Paediatric Surgery
  • Medicine
     
• All existing staff involved in EPPs must by 1st. May 2009 have a statement from the Occupational Health Service that they were non-infectious for and immune to Hepatitis B. If this statement is not available they will not be allowed to perform EPPs.