The risk management of HAI: A Methodology for NHSscotland

1 Background

Healthcare Associated Infection ( HAI) is a priority issue for NHSScotland. The profile of prevention and control of HAIs has been transformed within the past few years. Significant milestones include:

• A revised framework for national surveillance of healthcare associated infection in Scotland, HDL(2006)38, Scottish Executive Health Department ¹
• Preventing infections acquired while receiving healthcare : The Scottish Executive's action plan to reduce the risk to patients, staff and visitors 2002-2005 (2002) Scottish Executive Health Department ³
• Healthcare Associated Infection Standards (Revised 2008), NHS Quality Improvement Scotland ⁴
• Scottish Management of Antimicrobial Resistance Action Plan ( ScotMARAP) (2008) Scottish Government Health Directorate ⁵
• National Cleaning Services Specification (2004) Health Facilities Scotland ⁷
• A Framework for Mandatory Training in HAI (2004 ) NHS Education for Scotland ⁸

A major programme of work to improve the prevention and control of HAI across the NHS in Scotland was initiated by the Scottish Executive Health Department in 2002 with the production of the Ministerial Action Plan on HAI which concentrated on ensuring structures were in place to reduce infections. A second programme of work (focusing on implementation and delivery) building on the success of the first was developed and delivered between 2005 and 2008. The prevention and control of healthcare associated infection continues to be a top priority with a third three year programme of work being undertaken from April 2008.

An HAI Task Force working group was formed to develop the risk-based methodology to set priorities for targeting measures to reduce the risk of HAI and to facilitate action to ensure strict compliance with standards. This multidisciplinary working group included representation from NHS clinical and support services, members of the public, the non- NHS care sector including independent hospital representation and staff partners (full membership at Annex 4).

The draft document was consulted on and the risk based methodology was piloted in NHSScotland under the direction of Health Protection Scotland ( HPS). This pilot tested the methodology for applicability, utility and ease of use. This final document was amended by the Working Group to take account of the outcome of the pilot and consultation.