A History of the SHBN

A growing awareness of needlestick injuries

The Safer Needles Network began to evolve in the late 1990s with an increasing awareness about the problem of needlestick injury in the NHS and the potential for blood borne viruses that can result from them. Dr Philip Bickford Smith, who was then a Consultant Anaesthetist at Bradford Hospital had been running workshops in his area and the main NHS unions, RCN and Unison, had been campaigning on the issue alongside the BMA.

From the US, a campaign to prevent needlestick injuries emerged in San Francisco led mainly by nurses who were treating AIDS patients at a time when there were no retroviral drugs and this was taken up by the hospitals themselves in California and then nationwide. It resulted in a Federal US law in 2000 under President Bill Clinton called the Needlestick Safety and Prevention Act to reduce occupational exposure to bloodborne pathogens from accidental sharps injuries in healthcare and other occupational settings. OSHA, the US health and safety agency, and employers were required to identify, evaluate, and implement safer medical devices.

The birth of the Safer Needles Network

The Safer Needles Network (SNN) was formally set up in 2000 to bring together the existing strands of campaigning and activity in the NHS and to focus on finding a similar regulatory solution to the problem in the UK as had been legislated for in the US.

The membership of the Safer Needles Network developed from its original focus on organisations that represent healthcare workers, such as trades unions and professional organisations and individual clinicians with expertise in the area to include a wide variety of Government/NHS agencies and regulators, professional and trade bodies and manufacturers of the different technologies.

Initially the Department of Health was sceptical about the need for safer sharps and better practice but over time the Government and in particular the Labour health minister John Hutton said that something needed to be done as a result of the scientific research and political and media campaigning by the SNN.

A growing chorus calling for change

In 2003, the SNN contributed to a landmark report by the National Audit Office which recognised that needlesticks/sharps injuries were the second largest incident in the NHS. In the subsequent Parliamentary public accounts committee hearing there was astonishment that six workers in the NHS had died from contracting HIV from occupational exposure in the SNN’ evidence and even more so when the chief executive of the NHS incorrectly denied it! The political momentum was thus behind the prevention of needlestick injuries but the SNN still had much campaigning to do and it launched a nationwide campaign called Safer Needles Now! which was led by the 3 main NHS unions and had workshops all around the UK.

The Government issued better guidance and regulatory change backed up by the Health Act 2006 started to have an impact on the reduction in the number of injuries and the provision of safety devices. The active involvement of the HSE in wishing to address the number of cases that were building up led to the next stage of the SNN’s development. The HSE and the nascent CQC started to step up inspections to back up the increasing number of cases where NHS trusts were being prosecuted and a landmark legal case in Scotland also confirmed that lack of resources could not be used as an excuse for poor practice and the lack of provision of safer technology.

Introduction of Sharps Regulations advances a change in culture

In parallel with the SNN’s activities in the UK, the European Biosafety Network began its activity in 2009 in campaigning for European legislation to prevent needlestick or sharps injuries, with the unions (EPSU) and employers (HOSPEEM) eventually signing a framework agreement. The Sharps Directive 2010 was passed and was transposed into UK law as the Sharps Regulations 2013 with the expertise of the HSE and input from the SNN.

Enforcement and compliance but more than anything a change in behaviour and culture in the UK over the last 20 years has dramatically changed the way the NHS works in relation to sharps injuries and an uptake in safer sharps from just about 3% of the market converted in the early 2000s to about 80-90% in the late 2010s.

As the NHS adapted to prevent sharps injuries the SNN also worked with the care sector to ensure a level playing particularly in relation to the provision of diabetes and needle injection technique. The CQC issued its own FAQ and guidance to ensured that sharps injuries are dealt with properly as part of their regulatory role. In addition the HSE initiated a programme of inspection visits to ensure compliance with the Sharps Regulations 2013 and issued a number of notices and fines which helped to spread compliance further across the country. Dentistry was also a target as initially the sector did not believe the Regulations applied but when it was made clear by the HSE that it did the dentistry sector has progressively complied with the requirements of the Regulations.

The Network rebrands to the SHBN as its agenda broadens beyond sharps

Over the last few years the SNN has broadened its agenda to include other healthcare worker safety issues and in particular the exposure of workers and patients to hazardous and in particular carcinogenic drugs. The SNN is leading a working group to undertake an academic study funded by the NIHR to look at the impact of preventive measures on occupational exposure. The HSE also issued new guidance on how to handle cytotoxic drugs which are the main drugs used to treat cancer.

As part of this broadening the SNN decided in 2020 to rebrand as the Safer Healthcare Biosafety Network and to explicitly include the interrelationship between patient safety and healthcare worker safety which has always underpinned its activity. It also ensures that the UK work of the new SBN will be aligned with the European Biosafety Network.