The first 5 years of Part 2A Orders: the use of powers from court applications to protect public health in England 2010–15

BACKGROUND:Part 2A Orders are the legal means which allow local authorities (LAs), upon application to court, to exercise powers over persons, things or premises to protect public health. METHODS:We surveyed lead professionals involved in applications to understand the use and utility of such Orders since their inception in April 2010 to July 2015. RESULTS:All applications for Orders were granted; 29 for persons (28 for tuberculosis, 1 for HIV); these were renewed in 18 (18/25, 72%) cases up to seven times; 23 applications related to things (tattoo and piercing equipment); and three applications related to 'premises' (Escherichia coli 0137 on farm, faecal contamination). Use of the Orders against things occurred where there was failure of the Health and Safety Executive to transfer powers to LAs. Orders against persons were used as a last resort and renewed until treatment completion in the minority of cases (n = 3). One patient was detained under quarantine powers while assessing infectiousness. Significant difficulties in implementing the Part 2A Orders due to lack of resources, facilities and interagency collaboration were reported. CONCLUSIONS:Part 2A Orders are used as a last resort but improved facilities for safe and secure isolation would help improve implementation.