Thought leadership
technology forward in the sector: “We are preparing for a real-world evaluation of cleaning efficacy around the removal of bioburden on endoscopes, looking at the innovation that is emerging to tackle the issue – including brushless technologies. We’re about to start a trial very shortly on that, which is very exciting. “My colleague Darren Carter, who is the
IDSc’s director of research and technology, will be driving this forward. This work is giving the opportunity for our industry partners to be able to demonstrate some of the excellent research that is going on to solve some of the sector’s key challenges.” Other key areas being looked at by IDSc
include the development of standards around the emerging field of UV-C decontamination. The industry body is also updating HTM 01-01, through a dedicated working group. The aim is to bring together all the devolved nations to create a single, revised document aimed at upholding consistent, high standards in decontamination.
Other work is focused on tacking the questions
around the debate on ‘tray wrap versus reusable containers’: “There is a lot to consider – no single solution is right for everybody. It’s about providing our members with informed data around how they choose what’s best for their situation,” Dean commented.
Going forward For 2026, Dean summarised that IDSc will focus on: l Raising awareness of the decontamination sector’s important contributions.
l Supporting succession planning and professional development.
l Encouraging new people and organisations to collaborate, to ensure the IDSc is inclusive.
l Expanding IDSc’s international presence and influence.
l Positioning the organisation as the leading authority on standards, practice and innovation.
“It is a challenging time within the NHS, particularly around funding. However, we can provide the sector with the resources and materials they need to ensure safe patient care and support them with their learning. We can also ensure the guidance is up to date and remains relevant, giving people great reference tools to answer their questions and helping them to solve the challenges they are struggling with. “I continue to be inspired by the passion, expertise and resilience of our community. Together, we will continue to advance our shared mission, champion best practices and uphold the values that define our profession,” he concluded.
CSJ 58
www.clinicalservicesjournal.com I April 2026 COMMENT with Rob Warburton
Tackling endoscope contamination
Rob Warburton MBA CMgr FCMI MIDSc (Chtd) is the Decontamination Lead for Manchester University NHS Foundation Trust, IDSc Midlands Branch Chairman, and IDSc Director of Communications & Marketing. Here, he calls for improvement in current approaches to detection of contamination in flexible endoscopes. Flexible endoscopes are indispensable in modern medicine, yet their design makes them uniquely vulnerable to contamination. Unlike surgical instruments, they cannot undergo steam sterilisation; instead, high-level disinfection (HLD) is the terminal process. This limitation means any lapse in cleaning or disinfection can allow biofilm formation and survival of multi-resistant organisms, posing a serious risk of healthcare-associated infections (HCAIs). HTM 01-06:2016 Part E sets out a layered approach to verifying disinfection efficacy:
l Daily automatic control tests to confirm cycle parameters. l Process challenge devices (PCDs) to simulate real-world soil removal. l Protein residue testing for cleaning performance. l Microbiological testing of rinse water for pathogens such as Pseudomonas aeruginosa.
An SOP mandating quarterly lumen sampling strengthens this. This is mentioned in HTM 01-06, but few places conduct this test on a routine basis. HTM 01-06 explains using sterile peptone water and culture on R2A agar, with alert limits of ≥10 CFU/100 mL and strict remedial actions for pathogenic organisms. However, it does not specify the actions other than rewash and it does not distinguish between risk levels of organisms. To do so would be best practice and offer further resilience in testing above the guidance recommendation.
The challenge of lumen sampling Endoscopes have narrow, complex channels that are difficult to access. Even validated washer-disinfector cycles can leave residual contamination in dead spaces. Sampling requires aseptic technique, sterile flushing solutions, and careful recovery of eluates; yet, even then, results may underestimate contamination because biofilms adhere strongly to internal surfaces. Recent studies underscore the urgency: l An eight-year review revealed persistent duodenoscope contamination despite compliance with protocols (van der Ploeg et al., 2024).
l Biofilm accumulation was documented in new gastroscopes within weeks of clinical use (Primo et al., 2022).
l Outbreaks of carbapenemase-producing Klebsiella were linked to inadequately disinfected endoscopes (Haak et al., 2025).
l Alfa & Singh (2022) have highlighted how sampling methods impact culture results and root cause analysis.
These findings confirm that routine lumen sampling and disinfection effectiveness testing are not optional; they are essential for patient safety. Ultimately, routine lumen sampling and disinfection effectiveness testing:
l Provides early detection of process failures. l Demonstrates compliance with HTM 01-06 and ISO 16442. l Reduces risk of HCAIs and outbreak scenarios.
Closing thought In the words of Churchill, “To improve is to change; to be perfect is to change often.” In infection prevention, perfection is elusive, but vigilance, testing, and relentless improvement are our strongest weapons. Let us not be content with “good enough.” Let us fight on the beaches of biofilm, in the trenches of lumen sampling, and never surrender to complacency.
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