• Less than half of hospital trust boards had received an annual report in infection control, a legislative requirement
  • Trust boards are also failing to receive reports on the most serious gram negative infections
  • NHSI wants a greater focus by boards to help drive efforts to halve infection rates by 2021

NHS trust boards have been told to do more on infection risks after an analysis by NHS Improvement found many were not receiving detailed information.

Less than half of the 134 acute providers examined by NHSI had presented an annual infection prevention and control report to the board, despite this being a requirement under the Health and Social Care Act 2008.

NHSI has now written to all trusts asking them to prioritise reporting of gram negative bloodstream infections such as E coli, MSSA, klebsiella and pseudomonas.

It has also told trusts to make their annual infection prevention reports public and part of their board reporting process.

The review of trusts’ public board papers was carried out earlier this year amid “concerns that boards are less sighted on infection prevention and control particularly if MRSA and C difficle performance is good.”

The review found that while 100 per cent of trusts reported on MRSA and C difficile infections, less than 30 per cent reported on MSSA, less than 50 per cent reported on E coli and less than 10 per cent of boards were reporting on klebsiella and pseudomonas infections.

In May 2016, the government launched a drive to halve gram negative infections such as E coli by 2021 with a baseline of 32,000 infections in 2016-17.

While there has been some success, with rates of E.coli falling for the first time in five years, the overall target to reduce infections was missed in 2017-18.

NHS Improvement’s chief nurse Ruth May, who is also national director for infection prevention and control, told HSJ there was both a safety and economic case to tackling infections such as E coli because there are correlations between the levels of infection, excess bed days and patient mortality.

She said: “We are calling on provider boards across England to ensure they have consistent oversight and reporting on infection prevention and control, and a commitment to publishing annual reports and improvement plans.

“Boards should demonstrate their support of the infection prevention agenda and their clear engagement with the global standards, such as a continued focus on hand hygiene within healthcare settings, as well as the national improvement ambitions. We are now starting to see a slowdown in the increase of these types of infections, but must do a lot more together.”

A separate workforce survey by the regulator also found that 40 per cent of directors of infection prevention and control don’t have dedicated PAs, or programmed activity time, for the role. Only 20 per cent of infection control teams are working on plans to increase their team in the future.

Ms May told HSJ that tackling gram negative bloodstream infections was a national priority and would help contribute to efforts on anti-microbial resistance.

She said: “These types of infections are more likely to become anti-microbial resistant and can lead to the development of sepsis, so we have a shared responsibility to tackle this problem for the benefit of our patients and their loved ones.”

She said NHS was working with NHS England to support trusts and local systems as “the majority of these infections originate in the community, rather than in hospital.”