Source · Select Committees · Public Accounts Committee
Recommendation 28
28
Accepted
NHS staff inconsistently adhere to basic infection prevention and control procedures.
Recommendation
We asked about issues with infection prevention and whether some of the basics were not being upheld as much as they should. DHSC said that we should not underestimate how much of the battle against AMR “is really basic things”, including cleaning, handwashing and hospital design. It told us that the experience of COVID-19 led to mixed progress, improving handwashing but sometimes using inappropriate hygiene methods. It acknowledged that the NHS needed to get its staff, and not just doctors and nurses, back to following the basic procedures.70 NHS England told us that the introduction of the infection prevention and control manual has helped to standardise best practice.71 In a submission to us, the British Cleaning Council suggested that wider application of “Targeted Hygiene” in public places could help to reduce the spread of infections.72 67 C&AG‘s Report, para 1.9 68 Brian Duerden, Carole Fry, Alan P Johnson, Mark H Wilcox, ‘The Control of Methicillin- Resistant Staphylococcus aureus Blood Stream Infections in England’, Open Forum Infectious Diseases, volume 2, issue 2, March 2015 69 Q 45–46; C&AG‘s Report, para 3.10 70 Qq 43–46 71 Q 68 72 AR0011 17
Government Response Summary
The government agrees to prioritize infection control by embedding AMR into strategies, publishing an Infection Prevention and Control Workforce and Education Strategy by September 2025, integrating AMR prevention into medical training from 2026, and researching environmental controls and hospital design.
Government Response
Accepted
HM Government
Accepted
5.1 The government agrees with the Committee’s recommendation Target implementation date: Summer 2026 5.2 The government is prioritising AMR and infection control across the healthcare system. This includes embedding AMR into national and regional strategies, local Integrated Care Board (ICB) plans, clinical pathways, and provider contracts. AMR is, and will continue to be included in, performance and accountability frameworks for the NHS. 5.3 NHSE is supporting the workforce to reduce infections through: • A forthcoming infection prevention and control (IPC) Workforce and Education Strategy (September 2025), which will define national to provider-level responsibilities for embedding AMR and IPC. • Publishing a 10-year workforce plan to ensure that the number of medical specialty training places meets future NHS demands. • Integrating AMR prevention into undergraduate and postgraduate training for those graduating in 2026. • Publishing a capability framework for antimicrobial stewardship (AMS) roles, building on the existing framework for IPC staff. • Working with regulators to ensure AMR competencies are part of professional registration standards. • With UKHSA, implementing TARGET AMS tools across general practice. 5.4 Actions to address AMR in the NHS estate include: • Inclusion of emerging evidence on AMR into NHSE’s technical guidance and standards for existing estate. • Establishment of a cross-function working group on water safety to assess AMR risks within the built environment. • The New Hospital Programme, working with partners to deliver the next generation of NHS hospitals, aims to reduce AMR through innovative approaches to design and care models, informed by research and learnings from past healthcare failures. 5.5 The government agrees with the Committee’s recommendation Target implementation date: Spring 2027 5.6 As set out in the NAP, UKHSA has clear commitments to advance understanding around the spread of infection through using its modular ward. The modular ward will generate evidence on how the hospital environment contributes to the spread of AMR infection and how wards should be designed, refurbished and operated to enhance IPC. 5.7 UKHSA are studying environmental reservoirs of AMR organisms and assessing the effectiveness of controls in the built environment to prevent their spread. This includes investigating the impact of hand wipes and vacuums to prevent toilet aerosolisations. Evidence is being inputted into recommendations on surface cleaning and disinfection. The model ward will directly contribute to this through delivering training to IPC specialists. 5.8 Mitigating the risks associated with water and wastewater systems is a particular focus. The modular hospital ward is currently being used to inform sink, shower and toilet installation and design. Data are being used to inform the New Hospital Programme, enhancing existing guidance (NHS Estates Technical Bulletin (NETB) No.2024/3) and supporting and informing IPC strategies. 5.9 In addition to carrying out its own programme of research, UKHSA provides visiting academic researchers access to the modular ward facility and supports training programmes.