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INFECTION PREVENTION
Infection prevention and control: the role of commissioners
NHE talks to Rose Gallagher, Royal College of Nursing adviser for infection prevention and control, and Debbie Wright, assistant director of infection prevention and control at Aintree University Hospital NHS FT and a representative of the Infection Prevention Society, about a new ‘toolkit’ for commissioners.
No
person should be harmed by a preventable infection – this is a vision
shared by both the Infection Prevention Society (IPS) and the Royal College of Nursing (RCN), who have worked together to review infection control guidelines for commissioners following the NHS reforms.
The revised guidelines are aimed at both commissioners and providers, especially CCG leads on infection prevention and control (IPC), specialist IPC nurses supporting commissioners, directors of IPC at provider organisations and their teams, plus local authorities.
In his foreword to the guidance, Mike Durkin, director of patient safety at NHS England, says: “NHS England is pleased to support resources, such as this guidance, for providers and commissioners of care that will help them to establish a health care associated infection (HCAI) reduction plan, which reflects local and national priorities.”
‘We are the envy of Europe’
Rose Gallagher, IPC adviser at the RCN, helped lead the revision of the guidance following the changes to commissioning under the Health &
60 | national health executive Sep/Oct 14 Social Care Act 2014.
She told NHE: “We’ve come a tremendous way in the NHS across the UK in reducing some infections. The focus has been on MRSA and C. difficile, and we achieved that because we had the support of governments, we had leadership, we had investment in resources, and we had a suite of tools to support healthcare workers and provider organisations make those changes.
“We really are the envy of Europe insofar as what we’ve managed to do in reducing infections, but of course those are only two infections caused by two organisms. There’s an awful lot more work needs to be done and we’ve started that process: applying what we’ve learnt from MRSA and C. diff to other infections.
“We need to capitalise on that learning and continue to move forward – the job is not done.”
A separate briefing paper from October 2013 explaining where IPC fits into the complex and varied new commissioning landscape is also currently being updated.
Gallagher said: “That recognises that things change and that some improvements have been
made – for example, the de minimis limit for MRSA has been removed, but we still have it for C. diff for foundation trusts. But a different set of language is used for non-foundation trusts.”
Support for commissioners
Debbie Wright was another of the main authors of the revised guidance. She is now assistant director of IPC at Aintree University Hospital NHS FT, but was for many years responsible for IPC at Central Lancashire PCT, so is familiar with the issue from both a commissioner and provider viewpoint. In that role, she was a lead for the IPS/RCN Commissioning Network.
She said: “It is an important issue for commissioners. There’s differing levels of support available to commissioners in terms of IPC.”
She added that the NHS reforms did create initial confusion and concern about the future for IPC, because it was felt that some expertise would be “lost” as the structures changed: “It wasn’t clear where that function should fit with the commissioners. For example, some of the IPC commissioning expertise went directly into CCGs, some went to local authorities (that’s where my former post ended up), and some just
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