NHS LOTHIAN

OCCUPATIONAL HEALTH SCREENING

GUIDANCE FOR RESEARCH PASSPORTS

1.0Introduction

This guidance document is produced specifically for Researcherswho are applying to undertake research within NHS Lothian.

Clearance to undertake research activities within NHS Lothian can take the form of three separate but inter-related issues that need to be considered by the researcher, their Occupational Health Service (OHS) team as well as with advice as appropriate from the NHS Lothian OHS team. These include:

  • Fitness to undertake the research (e.g. modifications, disability);
  • ScottishGovernment requirements for health clearance in terms of patient protection;
  • Health and safety considerations such as immunisation.

This guidance document provides information on the different types of research and the level of Occupational Health Screening that may be required.

When determining what level of OHS clearance might be required for the research to be undertaken, work your way through the guidance starting at the ‘Basic Health Check Required’ level and work up to the appropriate level suited to what the research activity will actually entail.

The level of OHS check, if required, is determined by the research activities to be undertaken as opposed to the researcher’s substantive role. This is done by the researcher preparing (if not already done so for the research passport application process e.g. pre engagement checks) a short written statement confirming the actual activities that you will be undertaking to complete this research project. This statement should be submitted to the researcher’s substantive employer/registry at place of study to determine the appropriate level of OHS check required using this guidance document.

2.0Responsibilities

The researcher’s substantive employer/registry at place of study has specific responsibilities when it comes to assessing an individual’s fitness to undertake a research activity.The substantive employer/registry at place of study requires to undertake the necessary OHS check (at the appropriate level) and provide an assurance that the researcher is fit for task, and has the necessary immunisations etc.

If there is a need to consider modifications on the basis of disability etc, the substantive employer/registry at place of study must let NHS Lothian know so that these changes can be considered and NHS Lothian can ensure that its policies in terms of these issues are met.

The NHS Lothian OHS Team can provide advice on modifications that might be required to be considered or other specialist information based on what the research activity might involve.

3.0OHS Clearance Levels

1. Clearance for Casual/Social Contact

A basic assessment of general fitness and Health Clear clearance for TB disease/immunity. Thisis required where the researcher may havecasual or social contact with patients but is not directly involved in their patient care.

Examples of the type of research covered by this category include:

  • Telephone Interviewing;
  • Face-to-face interviewing;
  • Sensory testing;
  • Cognitive testing;
  • Dealing with laboratory information but excluding tissue or organ samples;
  • Paper file analysis;
  • Observational work.

2Clearance for Clinical Contact

This will be required where the researcher will have direct clinicalcontact with patients.

As defined in Annex A of “Health Clearance for Tuberculosis, Hepatitis B, Hepatitis C and HIV for New Healthcare Workers with Direct Clinical Contact with Patients” (2008) document, those involved in direct patient care include individuals

‘who have regular clinical contact with patients and who are directly involved in patient care.’

Examples of research activities where standard health clearance is required includedirect clinical activities common to

  • doctors,
  • dentists,
  • midwives
  • nurses,
  • occupational therapists
  • physiotherapists
  • radiographers.
  • Students and trainees in the above disciplines must also be included.
  • Dealing with laboratory information including working with tissue or organ samples

The recommendation is that the following is undertaken under the Standard Health Check:

  • have checks for tuberculosis disease/immunity;
  • hepatitis B immunisation is required, with post-immunisation testing of response (unless the individual is unfit for vaccination); and
  • are offered tests for hepatitis C and HIV.

As part of the OHS certification process, a discussion between the researcher and the OHS practitioner will determine whether or not the hepatitis B, C or HIV requirements need to be followed up, based on what the research will involve.

These standard health clearance checks should be completed pre-appointment before clinical research activities commence. All checks for TB disease/immunity must be completed before clinical research activities commence.

3 Clearance for Exposure Prone Procedures

This will be required where the researcher will perform exposure/prone procedures (EPP’s). The required checks must be completed before the research activities begin.

Exposure-prone procedures (EPPs) are those invasive procedures where there is a risk that injury to the researcher may result in the exposure of the patient’s open tissues to the blood of the researcher. These include procedures where the researcher’s gloved hands may be in contact with sharp instruments, needle tips or sharp tissues (e.g. spicules of bone or teeth) inside a patient’s open body cavity, wound or confined anatomical space here the hands or fingertips may not be completely visible at all times.

Additional health clearance means being non infectious for Hepatitis B and having evidence of a negative HIV (antibody negative)andHepatitis C (antibody negative or, if positive, negative for hepatitis C RNA) test.

Examples of research activities where EPP clearance is required include activities common to

  • Surgery,
  • Midwifery,
  • Dentistry (including work of Dental Therapists and Hygienists)
  • Some A & E activities.

This list is NOT exhaustive and the researcher/substantive employer/registry at place of studyMUST consider Annex B within the “Health Clearance for Tuberculosis, Hepatitis B, Hepatitis C and HIV for New Healthcare Workers with Direct Clinical Contact with Patients” (2008) document.

4.0Points to note regarding OHS Clearance Information/Certification

  • The length of time that a currentOHS clearance certificate can be accepted by NHS Lothian in connection with research activity applications is within the previous 3 years from the date that the application is originally submitted.(unless any declared health changes)
  • NHS Lothian will accept the substantive employer/registry at place of study's declaration that the individual is compliant with the necessary level of OHS check, taking the previous point into account.This compliance should be evidenced by including the researcher’s OHS ‘Fit’ Certificate with the Research Passport application form.

May 2013 (OHS/R&D/HR)1 of 4