FormWW5
Infectious Disease and Immunisation Screening
Please Read Carefully
This applies to all staff who are involved in patient care, patient contact, or handling of specimens.
1. For All Healthcare Workers
The Department of Health (DH) require you to be screened to establish that you are protected against and not suffering from, certain infectious diseases in order to protect both you and your patients. If this has been undertaken before in other NHS employment or at University/College you may not need it repeating so long as you can provide satisfactory documentary evidence. We would be grateful therefore if you could provide copies of any previous test results or immunisation records as outlined below AS SOON AS POSSIBLE. If you are unable to provide this information we will need to see you in Working Well and this may delay your start date.
We require the following evidence:
Tuberculosis / Documentary proof of BCG vaccinationOR / Documentary evidence of BCG scar from OH dept
OR / Documentary evidence of Heaf/Mantoux result within last 5 years
Rubella (German measles) / Blood test result or documentary evidence of vaccination details
Varicella (Chicken Pox) / History or blood test result or documentary evidence of vaccination
Mumps / Blood test result or documentary evidence of vaccination details
Measles / Blood test result or documentary evidence of vaccination details
Hepatitis B / Blood test result AND documentary evidence of vaccination details
- For Healthcare Workers from Abroad
In addition to the requirements in section 1 above, if you have lived or worked abroad for more than a month in the last 5 years as indicated on your Health Assessment form, we may need to contact you for a chest xray and mantoux (skin test). This will depend upon where you have lived and is a requirement of both Department of Health and recommended in the NICE guidelines. Your start date may be delayed until satisfactory checks have been completed.
- For All Staff
If you have previous results or documentary evidence, please send copies with your completed Health Assessment to our address above.
If you send originals please enclose a stamped self addressed envelope for return of your paperwork.
If you are unable to provide the documentation, please contact Working Well on 08454 225165 between 08:45 and 16:30 Monday to Friday and our staff will be pleased to make an appointment for you to have an immunisation check.
Once we have the necessary information, we will advise your manager whether you are assumed to be protected against the various illnesses listed above. If you do not provide this information or attend for an immunisation screening appointment your protection cannot be assumed and you may be restricted from working in some areas.
Healthcare Workers and Serious Communicable Disease
“Professional codes of practice from regulatory bodies require healthcare workers who may have been exposed to infection with a serious communicable disease, in whatever circumstances, promptly to seek and follow confidential professional advice about whether to undergo testing. Failure do so may breach the duty of care to patients.” DH 2007