1.1 In December 1999, Susan Deacon, Minister for Health and Community Care, launched the "Towards a Safer Healthier Workplace, the Occupational Health and Safety Strategy for NHSScotland staff". The guiding principle was that staff are the most important resource in the NHSScotland and should be able to carry out their work without fear of risk to their health or safety. As stated, "no one should be made ill by their work". This commitment was reinforced in "Our National Health; A plan for action, a plan for change".
1.2 The Strategy committed all those involved in the NHSScotland; staff, management, trade unions, professional organisations and the Scottish Executive, to work together towards improving the health of staff at all levels and making the workplace a safer place for staff, patients and visitors. For the purpose of this report the term NHSScotland employer applies equally to Trusts and Health Boards and should be read across and commended to independent contractors such as General Medical and Dental Practitioners and Community Pharmacists in relation to their status as employers. References to Chief Executives should also be read across to their equivalent for General Medical and Dental Practitioners and Community Pharmacists as independent contractors.
1.3 Needlestick injuries were highlighted in the Strategy document as one of the most common types of injury to staff in the NHS Scotland. They are also injuries that often go unreported. The Needlestick Injury Short Life Working Group was established in March 2000 to investigate the prevalence, cause and prevention of such injuries and to make recommendations to minimise the risk to staff. Whilst the focus of the group has principally been the cause and prevention of needlestick injuries, many of the recommendations have relevance to wider Health and Safety issues in the NHSScotland.
1.4 The major health risks associated with needlestick injury result from blood-borne viruses. However, not all needlestick injuries carry the risk of infection. Many needles will not have come into contact with patients. Conversely, the transmission of blood-borne diseases does not result solely from needlestick injuries and may be a consequence of a range of other exposures to infected blood or microbiological hazards.
1.5 The group recognises that there are differences between the risks associated with hollow-bore and solid needles but the principles of prevention should apply equally to all sharps and to any situation where exposure to blood-borne viruses is possible. A key message in the recommendations which follow is that healthcare workers should only use needles for procedures where it is absolutely necessary and that all procedures must be risk assessed. Where needles are used, existing policies on their use and disposal should be implemented and regularly reinforced to minimise risk to staff and patients. The Group is very aware that while some safer devices are available, they are not applicable to all clinical procedures.
REMIT OF THE SHORT LIFE WORKING GROUP
1.6 To review the available data and information on preventing needlestick injuries, make recommendations on good practice and specifically consider the value of safer devices and make recommendations on their possible use in the NHSScotland. The review to be based on risk assessment and take account of current practice and procedures and of the cost and benefit to the NHSScotland of current and alternative practices. Recommendations to the Minister by the group should be practical, achievable and affordable and take account of current and planned Health and Safety laws.
METHODOLOGY
1.7 The Working Group convened for the first time at the end of March 2000 and met on five occasions. Information was collected from a range of different sources including professional organisations and trade unions, the Health and Safety Executive (HSE) and its Health Services Advisory Committee (HSAC); US organisations such as the Occupational Safety and Health Association (OSHA), Centers for Disease Control and Prevention (CDC); Training and Development of Innovative Control Technology (TDICT), and from NHSScotland Trusts and Health Boards. Current and planned Health and Safety Legislation was considered although it should be noted that Health and Safety is a reserved matter under the Scotland Act 1998.
DATA PROTECTION ACT
1.8 Application of the recommendations in this report must maintain individuals' anonymity in accordance with the Data Protection Act.