IPC Structures and Transmission Risk

1.1 The Welsh Government agrees that, in any future emergency or pandemic, decisions about infection prevention and control must be based on clear responsibilities and decision making, expert advice, and a cautious approach to risk. The Welsh Government also recognises that, in a future pandemic, guidance should consider all possible ways an infection might spread until there is enough evidence to rule any of them out. 1.2 The Welsh Government and Public Health Wales are participating in a UK‑wide work programme to review current UK infection prevention and control arrangements. This work will help ensure that future pandemic advisory structures have clear roles, are accountable, and include the right range of expert advice. 1.3 In Wales, we will ensure that future guidance takes account of uncertainty at the start of a new and emerging infectious disease outbreak and will consider all possible ways an infection might spread until the evidence becomes clearer. Guidance will also explain why particular precautions are recommended, so they can be applied consistently across health and care settings. 1.4 Wales has adopted the National Infection Prevention and Control Manual, developed by NHS Scotland. Public Health Wales will continue to work with UK partners to review guidance so that future assessments of transmission risk consider the wider context, including how easily the infection spreads, environment, the type of care setting and the care being provided.

1.5 Alongside the four‑nations work, the Welsh Government is strengthening national leadership, and oversight for infection prevention and control in Wales. The recently published Infection Prevention and Control Quality Statement sets out how infection prevention and control should be improved across health and care settings in Wales. It supports a preventative, evidence‑based approach to reducing avoidable harm and improving health outcomes. It also supports the long‑term, preventative approach set out in the Well‑being of Future Generations (Wales) Act 2015. 1.6 The revised Healthcare Associated Infection Code of Practice supports implementation of the quality standards; it sets out the basic infection prevention and control standards that NHS organisations in Wales are expected to meet. Health boards and trusts are expected, as part of the code of practice, to complete a gap analysis against the Infection Prevention and Control Quality Statement. NHS organisations in Wales will need to show patients, staff and visitors that they are meeting these standards. Their progress will continue to be checked through local assurance arrangements, with oversight from the Welsh Government and Healthcare Inspectorate Wales. 1.7 To support strengthened accountability and oversight, health boards and trusts will appoint a Director of Infection Prevention and Control by summer 2027, with clear executive reporting arrangements. An All‑Wales assurance framework will also be developed to help organisations check whether they are meeting infection prevention and control requirements, identify where improvement is needed, and support oversight by governance boards.

Whilst this recommendation is not directed at the Scottish Government, a range of work is underway to strengthen structures and drive improvement on the ground:

The Scottish Government is committed to working closely with the UK Government, and other devolved governments, on proposals in relation to pandemic preparedness as it relates to IPC (Infection Prevention and Control) structures. The Scottish Government recognises the importance of engaging on a four nations basis and has already met with the UK Government and other devolved governments to discuss what structures may be convened to support working in the event of, and responding to, another pandemic

On 27 July 2026, Scotland became the first nation in Europe to publish an integrated Infection Prevention and Control (IPC) Strategy covering both health and social care. The strategy aims to reduce preventable infections across all settings, including hospitals, care homes and community care. The strategy identifies eight priority areas, including stronger governance and leadership, enhanced IPC programmes, improved data and surveillance, and expanded workforce education and training. It is the first dedicated Scottish Government IPC strategy covering care homes and social care, reflecting lessons learned from the Covid-19 pandemic. The next phase of this work will be the development of three-yearly action plans with stakeholder oversight and assurance built in from the outset. The action plans will have a focus on turning the policy ambition into change on the ground, for example by strengthening IPC practice, scrutiny and organisational roles and responsibilities. To inform this work Scottish Government is funding the ALLIANCE to facilitate community engagement, including from those impacted by health and care associated infections, ensuring experiences can influence the action plans and outcomes

Public Services Delivery (PSD) Scotland was formed on 1 April 2026, replacing NHS Education for Scotland (NES) and NHS National Services Scotland (NSS). It is a national delivery organisation that brings together expertise in national infrastructure, digital and data services, clinical service delivery, education and workforce development, planning, and transformation to support better outcomes for people and communities across Scotland

The organisation plays a key role in informing policy development and implementation by providing evidence, professional knowledge, analytical capability and operational experience. Working across organisational and professional boundaries, PSD Scotland supports the design, delivery and improvement of services that meet the needs of people, communities and the workforce

On 3 August 2026 PSD Scotland published the updated Transmission-Based Precautions (TBP) guidance within both the National Infection Prevention and Control Manual (NIPCM) and the Care Home Infection Prevention and Control Manual (CHIPCM). Ahead of publication and reflecting broad stakeholder involvement in the development of the guidance, NHS Boards have been preparing for implementation of this evidence-based guidance. Scottish Government is committed to working with PSD Scotland, Health Boards and providers in other health and social care settings to support staff in operationalising updated IPC Guidance in the National Infection Prevention and Control Manual

The government recognises the importance of clear, accountable structures to support IPC decision making during a pandemic and agrees with the Inquiry’s recommendation.

No statement on delivery from Department of Health and Social Care has been found in the sources searched. This is separate from the response above.