ABSTRACT
OBJECTIVE: To describe an approach to implementing the principles of clinical governance in a Health Board setting. DESIGN: Using guidance from the Scottish Executive and The Faculty of Public Health Medicine to set up a health governance structure at Health Board level. Auditing current work to identify areas that required to be progressed. SETTING: Lanarkshire Health Board. RESULTS: A Health Governance Committee and a Health Governance Advisory Group, to support the work of the main committee, were set up at Board level. The Scottish Executive Governance Monitoring Template has been adapted to cover the main public health functions. Topics considered in the first year include qualifications, registration and CPD activity of Consultants in Public Health Medicine, audit of public health advice on gastro-intestinal illness, audit of DPH Annual Report and audit of items of business on Health Board agenda. CONCLUSION: The model developed in Lanarkshire has a Health Governance Advisory Group which works in support of the main Health Governance Committee. This model works well in practice with much of the routine work being done by the Advisory Group. This has streamlined the work of the Health Governance Committee and facilitated its introduction.
Subject(s)
Primary Health Care/standards , Quality Assurance, Health Care , State Medicine/standards , Health Services Research , Humans , ScotlandSubject(s)
Disease Outbreaks , Legionellosis/epidemiology , Child , Child, Preschool , Female , Humans , Legionellosis/diagnosis , Male , Scotland/epidemiologyABSTRACT
Analysis of case histories from 187 people who had visited a hotel and leisure complex in Lochgoilhead, a village on the west coast of Scotland, indicated that 170 had had an acute illness characterised by headache, fatigue, arthralgia, myalgia, cough, and breathlessness. These symptoms were consistent with Pontiac fever-like illness. Legionella micdadei was isolated from the leisure complex whirlpool spa at the time that 60 of 72 individuals with symptoms seroconverted to L micdadei antigen. This outbreak is thought to be the first of a Pontiac fever-like illness ascribed to L micdadei and the first large-scale outbreak of its kind to have occurred outside North America. Whirlpool spas can be a major reservoir of legionella organisms; they must therefore be properly maintained and operated to prevent outbreaks of infection.
Subject(s)
Fever/epidemiology , Legionellosis/epidemiology , Legionnaires' Disease/epidemiology , Acute Disease , Adolescent , Adult , Aged , Antibodies, Bacterial/analysis , Child , Child, Preschool , Female , Fever/etiology , Fever/immunology , Humans , Hydrotherapy/adverse effects , Legionella/classification , Legionella/immunology , Legionella/isolation & purification , Legionellosis/complications , Legionellosis/immunology , Legionnaires' Disease/complications , Male , Middle Aged , Scotland , Time Factors , Water MicrobiologyABSTRACT
Men between the ages of 25 and 45 years attending a surgery were screened for risk of heart disease. An ;at-risk' group of 188 men were identified and 118 of them (63 per cent) accepted an invitation to attend a coronary heart disease prevention clinic at the practice. A sample of the attending group showed favourable changes in risk factors one year later.Subsamples of 20 men from the attending and non-attending groups were interviewed at the clinic or at home; they showed significant differences with respect to employment status, family history of myocardial infarction and knowledge about coronary heart disease as a cause of death in the United Kingdom. Implications for preventive programmes of this nature are discussed, and the need to utilize routine doctor-patient contacts for health education and prevention is stressed.
