Healthcare Associated Infection (HCAI) strategy 2023 to 2025

Foreword by Chief Nursing Officer (CNO)

The COVID-19 pandemic has had an unprecedented impact across health and social care and, as we emerge from the most significant public health crisis of our time, it is important to build upon the appetite for effective IPC measures to ultimately reduce HCAIs.

Prior to the pandemic, Scotland was continuing to make great strides in reducing the incidence of HCAIs across healthcare and the community. As the pandemic unfolded, resources were rightly diverted to support our response. The time is now right to revisit and refocus on reducing HCAIs.

This strategy is intended to support the recovery from the pandemic response and reduce HCAI rates. The strategy highlights the importance of ongoing education and training, surveillance, and monitoring. By adopting this strategy, we can regain progress interrupted by COVID-19 and continue to improve patient outcomes.

Some of the challenges associated with IPC and HCAI reduction, however, are not solely restricted to infection prevention. NHS capacity, built environment, and staffing levels are some areas that require wider whole system leadership and change. For that reason, I would like to emphasise that this strategy is not intended to be viewed in isolation and should be used in conjunction with other frameworks and strategies to help achieve our vision.

One such strategy is The Infection Prevention Workforce: Strategic Plan 2022 – 2024. Published in December 2022, this plan provides a framework through which we can work together to meet our goal of having an appropriately skilled, resilient, sustainable, and confident IPC workforce across all health and care settings.

The UK Antimicrobial Resistance[3] (AMR) National Action Plan (NAP) should also be considered alongside this strategy. The World Health Organisation (WHO) has identified AMR as one of the top ten global health threats.

As Scotland’s Senior Responsible Officer for the delivery of policy outputs of the UK AMR NAP, I am committed to prioritising the reduction of infections in our health service. Effective IPC and antimicrobial stewardship (AMS) will reduce the occurrence and control the spread of HCAI, which will in turn reduce the need for the use of antimicrobials. It should be noted that AMS plays a crucial role in mitigating against AMR and is not explicitly referenced within this document.

It would also be remiss of me not to mention the key role that social care settings have in infection prevention. Indeed, if we are to continue in our progress of improving patient and service user care, as well as preventing AMR, then reducing infections in social care settings is vital. Although this strategy and the included deliverables focuses on healthcare settings, I would invite social care colleagues to consider the strategic goals within this document as these have been written to be inclusive of all health and care settings. This is the first step in what I hope will be a fully comprehensive IPC strategy in the future.

Lastly, I would like to extend a personal thanks to our workforce across Scotland’s health and social care service for their tireless efforts and vital work during the pandemic response, and their continued commitment in reducing incidence of HCAIs.

Sincerely, Professor Alex McMahon Chief Nursing officer