Introduction

The Public Health Laboratory Service was established under the 1946 National Health Service Act. Its aim is to protect the population from infection through detection, diagnosis, surveillance, prevention and control of infection and communicable diseases. It achieves this aim through a network of microbiology laboratories, epidemiology and field investigation services, research and development, and education and training programmes. This requires collaboration with NHS and local authorities, Universities and other institutions, central Government and world-wide collaboration on the sources and control of infections.

There are 49 laboratories in the network based in NHS Trusts in England and Wales and organised into 9 Groups. At the heart of the network is the PHLS Headquarters at Colindale in North London together with the Communicable Diseases Surveillance Centre (CDSC) and the Central Public Health Laboratory (CPHL).

The PHLS Board is chaired by Sir Leslie Turnberg, with eighteen members drawn from academia, industry, the NHS and local authorities.

Achievements in 1996/97

The PHLS made changes to its structure and operations to ensure an effective and efficient service. The network of public health laboratories was restructured into nine regional Groups, each with a devolved budget. Regional Epidemiology Units have been set up to provide support to health professionals with statutory responsibility for communicable disease control. Standard operating procedures in clinical microbiology were developed to enhance quality control. Internal communications were improved within a newly established Group structure and a National Joint Staff Consultative Committee was established. A Training Action Plan was also established for PHLS staff.

During 1996/7 the Service responded successfully to several major national incidents. The PHLS detected a small number of false negative HIV results associated with a particular test kit. This led to a national programme of rapid re-testing and follow-up of patients. The Service investigated clusters of meningococcal infection and provided expert advice and operational support, which was enhanced by investment in new technology. Outbreaks of Salmonella associated with cheddar cheese and infant formula feed were detected and investigated.

During the year, the PHLS provided more information on and increased public understanding of its services. A Code of Practice issued in 1996 sets out information that can be made available, how complaints can be made and how soon a reply can be expected. During the National Week of Science, Engineering and Technology, the PHLS held open days, exhibitions in shopping centres and schools and collaborated with Universities to provide sixth form lectures. An exhibition about the history of the PHLS was opened at the Science Museum in London during celebrations of the PHLS's Golden Jubilee. To celebrate its fiftieth anniversary, a description of the work of the PHLS was distributed with private sector funding. Collaborations with local press have also been established, such as the Hendon Times 'Bug of the Month' series of reports.

Most laboratory premises are owned by host NHS Trusts and several are being redeveloped under the Private Finance Initiative. The PHLS is considering the potential for PFI to provide computer based integrated financial accounting systems.

Most non-core activities at the Colindale site are contracted out, including security, catering and cleaning. Customer satisfaction surveys were conducted in the Service on core business activities to inform service delivery requirements.

The PHLS has piloted accreditation to Investors in People at its laboratory in Norwich, and is looking to extend this to the whole East Group and the Colindale site.

Plans for 1997/98

Key developments in 1997/8 will include developing specific disease-based programmes and enhancing the provision of services in London. Quality controls will be improved through further development of standardised procedures. Reviews will also continue of surveillance, reference and research work to release resources from completed and lower priority activities for reinvestment in high priority developments.

Key Performance Targets

1997/8

• To enhance PHLS effectiveness in London by reviewing PHLS services to London by June 1997 and reinvesting resources released by the withdrawal from Whipps Cross and Tooting PHLs by 31 March 1998.

• To develop a new approach to the work of the PHLS based on a series of specific disease-based programmes involving both the Centres at Colindale, the Group Laboratories and the Regional Epidemiologists, taking full advantage of the closest possible integration of PHLS microbiological and epidemiological services and expertise.

• To work with the Department of Health in implementing the recommendations of the Prior Options Review to an agreed timetable.

• To ensure that Groups and Centres provide microbiology and epidemiology services which are of exemplary quality, and customer-focused by agreeing Service Level Agreements with Local Authority Environmental Health Departments by September 1997 and draft Memoranda of Understanding with CsCDC to be ready for implementation by 31 March 1998; and that surveillance information is underpinned by accredited laboratories working to PHLS standard methods.

• To ensure the closest possible alignment of PHLS activities with public health priorities through a rigorous programme of reviews of surveillance, reference and research work which will release resources from completed and lower priority activities for reinvestment in high priority developments.

• By 31 December 1997 to have Memoranda of Understanding with four Institutes, to enhance the PHLS's capacity and effectiveness to undertake Research and Development and Education and Training through collaborative projects with other relevant institutions.

• To ensure that financial plans, budgets and systems are in place and closely monitored so that total PHLS expenditure is contained within total PHLS income and that all statutory financial requirements are met.

• To agree with the Department of Health and Welsh Office a plan for effecting efficiency savings up to 2000/2001.

Key Performance Targets

See above text