Summary: roles and responsibilities

NHS Ayrshire & Arran guidelines
NHS Ayrshire and Arran

Emergency Department

  • Assessment of patients and treating wounds.
  • Contacting Infection Specialist On-call.
  • Administration of initial rabies vaccination +/- HRIG.
  • Referral for any required OOH vaccines to RAC/CAU/Ward 1A/C.
  • Administration of any rabies vaccination +/- HRIG following GP/AUCS assessment where there are wounds that require management.

Rapid Assessment and Care (RAC)/Combined Assessment Unit (CAU) (for adults)

  • Administration of any rabies vaccination +/- HRIG required OOH where previous arrangements with the Immunisation Coordination Team have not yet been made.
  • Administration of any rabies vaccination +/- HRIG following GP/AUCS assessment where there are no wounds that require management.

Ward 1A/C (for <16 years old)

  • Administration of any rabies vaccination +/- HRIG required OOH where previous arrangements with the Immunisation Coordination Team have not been made.
  • Administration of any rabies vaccination +/- HRIG following GP/AUCS assessment where there are no wounds that require management.

Primary Care/Ayrshire Urgent Care Service (AUCS)

  • Assessment of patients.
  • Contacting Infection Specialist On-call.
  • Referral to CAU for any required vaccines +/- HRIG during OOH period if no wounds require management.
  • Referral to ED for any required vaccines +/- HRIG if there are wounds that require management.

Infection Specialist (NB: this may be the Infectious Diseases consultant in NHSAA, Lanarkshire, other)

  • Support the risk assessment of exposed individuals.
  • Advise treating clinician of any immediate actions required and vaccines required during OOH period.
  • Referral to Immunisation Coordination Team and HPT for further vaccination.
  • In PrEP, determining eligibility for NHS vaccination. Determining the need for antibody titres, arranging testing and acting on results.

Immunisation Coordination Service

  • Appointing and administration of rabies vaccine to patients.
  • Inform General Practice by letter of vaccinations administered.

Health Protection Team (HPT)

  • Identification of any human exposures relating to an APHA report of animal with possible/confirmed rabies.
  • Provide PSDs for rabies vaccine for Immunisation Coordination Team.
  • Provide point of contact for patient follow up after exposure event if no other issues.

Pharmacy

  • Maintaining supply of rabies vaccination within identified clinical areas.
  • Coordination of  HRIG supply when required.
  • Provide on call advice for vaccine or HRIG supply.