The Health Protection Notification Regulations 2010 (HPNR) help us respond promptly to suspected cases of infectious disease that could have an impact on public health. The COVID pandemic shone a light on the fundamental role of surveillance in supporting an effective public health response.
Schedule 1 of the HPNR lists ‘notifiable diseases’, with organisms that could lead to the development of a specific infectious disease – known as ‘causative agents’ – listed under schedule 2.
Registered medical practitioners in England are required to notify the relevant local authority or local health protection team if they treat a patient they know or suspect to have a notifiable disease. Diagnostic laboratories must also report causative agents to the UK Health Security Agency (UKHSA) once detected.
Recently, we have made amendments to the HPNR at pace in response to outbreaks involving new or emerging infectious diseases. During the pandemic, COVID was added to schedule 1 and 2, and in June 2022, mpox (then known as monkeypox) was added to schedules 1 and 2 in response to rising cases in the UK.
However, a full review of the HPNR has not taken place since 2010, when amends were made after a 3-month public consultation in 2009. It is important that a review takes place now to ensure schedules 1 and 2 reflect current public health needs.
We are therefore launching a 3-month consultation seeking views from stakeholders to understand the potential impacts of the proposed amendments. This is an opportunity to gather views on the implications of the proposals before any decisions are made on taking them forward. Decisions will not be made until the responses to the consultation have been fully considered.
There are 3 proposals.
- Seven infectious diseases could be added to schedule 1, list of notifiable diseases.
- Twelve causative agents could be added to schedule 2, list of causative agents.
- There should be an expansion of the current reporting requirements placed on diagnostic laboratories in England that test human samples to also report negative and void test results, in addition to the positive test reports as is already required. This requirement was introduced for SARS-CoV-2 during the pandemic, which enabled UKHSA to attain greater granularity in data for surveillance.
The 7 infectious diseases proposed for addition are:
- Middle East respiratory syndromes (MERS)
- influenza of zoonotic origin
- chickenpox (varicella)
- congenital syphilis
- neonatal herpes
- acute flaccid paralysis or acute flaccid myelitis (AFP or AFM)
- disseminated gonococcal infection
The 12 causative agents proposed for addition are:
- Middle East respiratory syndromes coronavirus (MERS)
- non-human influenza A subtypes
- norovirus
- echinococcosis spp
- tick-borne encephalitis virus (TBEV)
- Toxiplasma (congenital toxoplasmosis)
- trichinellosis spp
- Yersinia spp
- respiratory syncytial virus (RSV)
- Neisseria gonorrhoeae (from a sterile site)
- Treponema pallidum
- Neisseria gonorrhoeae (non-sterile site)
It is important to note that personal information around cases of notifiable diseases shared under the HPNR is strictly confidential, and will only be seen by those with a clearly defined need, such as public health staff managing a case.
The proposed additions to schedule 2 include Treponema pallidum (syphilis) and Neisseria gonorrhoeae (gonorrhoea). Following the consultation, a dedicated impact assessment focused on the potential addition of these 2 infections will be conducted, engaging stakeholders including patient representatives. This process aims to ensure that any unintended consequences are fully considered.
Submit your views through the consultation on the Health Protection (Notification) Regulations 2010: proposed amendments.