As NHS managers, we must reduce the harm caused by avoidable infections.

It is easy to get into a debate as to what is avoidable, but this distracts from the cultural change we need - zero tolerance to infection.

Delivering high-quality care means no needless pain, suffering, anxiety or death. High-quality care requires effective use of our resources with no unnecessary delay or waste.

Infection impacts on every aspect of the quality of patient care and the efficiency and effectiveness of our services. Infection adds three to 10 days to length of stay, with infection by Clostridium difficile adding an average 21 days. Infection can cost a trust an extra£4,000-£10,000 per patient. At every level, the need to reduce the harm caused by infection is compelling and irrefutable.

Over the past two-and-a-half years, an incredible amount of focus and effort has been put into the task of reducing MRSA and other infections. There have been considerable reductions in healthcare-acquired infection in many organisations.

While the national picture is looking significantly better than it did, there is still a long way to go. There is great variation in the levels of improvement and some trusts are struggling.

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