CCDC

CCDC - Consultant in Communicable Disease Control. (Plural - CsCDC.) Sometimes also known as Consultants in Health Protection, or Consultants in Public Health (Environmental Health).

The post of CCDC was created by the Acheson Report, and is defined by English law. Although communicable disease control is a large part of a CCDC's work, a CCDC usually also prepares for and advises on non communicable environmental hazards. For this reason some prefer the title of Consultant in Health Protection; this title is less obviously meaningful, but does at least not appear to imply that the job only includes some aspects of what it actually involves.

In England, CsCDC were employed by Health Authorities until the implementation of "Shifting the Balance of Power". They them moved into the Health Protection Agency, working in Health Protection Units (HPUs); and then on 1 April into Public Health England, working in a Public Health England Centre (PHEC) - nothing to do with Father Ted - or a Health Protection Team

There is a professional group primarily for CsCDC - the Public Health Medicine Environment Group (PHMEG). (Much of the content of this page was originally written for the PHMEG website.)

History of the CCDC

• 1871 - 1974: Responsibility for the control of disease in the community assigned to MOH, who was located in local political authority, but responsible for public health services.
• 1974: MOH abolished and responsibilities for disease control given to medical officer of environmental health (MOEH), placed in local health authority, rather than local political authority.
• 1974: Community physicians created.
• 1982: NHS reorganisation  many community physicians retired as posts seen as a “dead end” for poorly qualified physicians.
• 1984: Salmonella food poisoning incident in Wakefield.
• 1985: Legionnaire’s disease outbreak at Stafford.
• 1985: As a result of the two communicable disease outbreaks Committee of Inquiry (chaired by Sir Donald Acheson) established to consider public health rôle.
• 1988: Results of inquiry published as Acheson report.  DoH circular HC(88)648. Health Services Management, Health of the population: responsibilities of Health Authorities. London: Department of Health, 1988] CCDC (initially district control of infection officer) posts created, in DHAs. Also recommended establishing schools of public health to train CsCDC. Failed to clarify relationship between CsCDC and EHOs.
• 1989: DoH Review of law on infectious disease control - consultation document published9.
• 1989: Creation of purchaser/provider split.
• 1990: Rôle of CCDC summarised (by Yorkshire RHA). The CCDC should:

• Act as the executive officer responsible for enabling the DHA to fulfil its statutory obligations in relation to :communicable disease and infection.
• Take a lead rôle in the co-ordination of communicable disease on a district-wide basis.
• Be the key person to advise the DHA on communicable disease control and for ensuring that there was a comprehensive policy for such control that would cover all contracts placed and for monitoring these.
• Ensure that any regional arrangements for the management of communicable disease affecting more than one DHA were complied with.
• Act as the “proper officer” for the relevant local authority.
• Act as the Port Health Officer or Inspector, AIDS Co-ordinator, and the Immunisation Co-ordinator.

• 1991: NHSME EL(91)12310 Communicable Disease Control emphasised rôle of CCDC and of collaborative arrangements and stated that “binding decisions which will cut across the DHA and the local authority will be deferred until the consultation document Review of Law on Infectious Disease Control will be announced”.
• 1992:Guidance published by NHSME, saying that local authorities and DHAs should “ensure that joint plans have been drawn up in consultation with the CCDC, the EHO, the Public Health Laboratory Service (PHLS), FHSAs and the Port Health Authority where appropriate”.
• 1993: Abrams report asserted that:

• “the public health function underpins all NHS purchaser and provider activity
• “the DHA and its DPH should provide the focus for a comprehensive public health strategy”
• the CCDC, rather than the EHO should take the lead in the control of communicable diseases
• the CCDC should be designated the “proper officer” by the local authority
• CCDC should be managerially accountable to the DPH
• DHA should fund the CCDC adequately.
• Local authority exhorted to “provide professional and other staff to support the CCDC’s work”.
• Failed to adequately resolve ambiguity of CCDC rôle.
• Late 1993: Managing the new NHS13 announced abolition of 14 RHAs and replacement with 8 Regional Offices of the Management Executive (effective from April 1994.)

(Needs to be continued. Main changes since were Shifting the Balance of Power, which abolished HAs and created PCTs, Getting Ahead of the Curve, which created the Health Protection Agency, and then the move to Public Health England.)