Cutting infection prevention funding is a false economy

With government plans to reduce rising rates of E. coli in England announced last year and a renewed emphasis on the importance of hand hygiene and infection prevention in healthcare settings, it is clear that infection prevention and control (IPC) experts and teams will be central to achieving this vision.

In addition, one of the greatest threats to health and the delivery of safe healthcare is the rising tide of antimicrobial resistance (AMR). IPC is recognised as a vital element of the United Kingdom Antimicrobial Strategy; indeed it is “Key Area Number 1: Improving infection prevention and control practices”.

The Infection Prevention Society welcomes the renewed national emphasis on IPC and our experience in England shows us that greater investment in infection prevention and control achieves results. In 2007, MRSA bloodstream infections and Clostridium difficile infections (C. diff) were recorded as the underlying cause of, or a contributory factor in, approximately 9,000 deaths in hospital and primary care in England.

Since 2010 the number of MRSA cases have been reduced by 57 per cent and C. diff cases by 45 per cent. There can be little doubt that these reductions were achieved, in part, by increased investment in IPC resources and expertise.

Therefore, it’s worrying that the skilled teams responsible for carrying out this new vision are being reduced or cut across some parts of the UK, with greater responsibilities being added to already heavy workloads.

Significant saving

A recent poll of our members – professionals working in infection prevention and control – reveals that almost a third (30 per cent) who responded have seen a reduction in the IPC services where they work, with 28 per cent reporting a reduction in IPC posts or hours. A further 35 per cent said they have been asked to do additional non IPC responsibilities as part of their job.

Ensuring effective IPC practices in all health and care settings is an essential way of preventing infection from developing and spreading and there is clear evidence that early intervention through infection prevention saves lives as well as significant cost to the NHS. It is estimated that 300,000 patients a year in England acquire a healthcare-associated infection as a result of care within the NHS, with an estimated cost to the NHS of at least £1bn a year.

This is without considering the costs of increasing AMR; effective IPC prevents the spread of resistant organisms and every infection that is prevented is one more person who doesn’t need a course of antimicrobial treatment.

While some hospitals and healthcare providers recognise this (with 65 per cent of our members reporting that infection prevention services are being extended or maintained and anecdotally, we hear that some organisations have protected IPC budgets from cuts completely) others are cutting back. This will have an inevitable impact on patient safety and could cause significant disruption to health service delivery.

Of our members experiencing cuts to IPC services in their organisation, 29 per cent said their biggest concern associated with this was ‘serious risk to patient safety through infection spread’, followed by 9 per cent saying their key worry was ‘not being able to meet new national requirements such as E. coli targets in England’.

‘We are calling on NHS leaders, commissioners and healthcare providers to maintain investment and help us reach these goals’

The English government’s ambition of a 50 per cent reduction of healthcare associated gram-negative bloodstream infections by 2020/21 - including E. coli – will only be achieved if these vital services are protected. Infection prevention teams are working towards these goals, including investigating cases of bacteraemia, preventing avoidable infections such as catheter associated urinary tract infections and educating healthcare workers about the threat from Gram negative bloodstream infections and how to prevent them.

However, we can’t do this without continued funding and we are calling on NHS leaders, commissioners and healthcare providers to maintain investment and help us reach these goals.

Healthcare teams can also play their part by making the most of best practice guidance available on infection prevention to keep patients, staff and visitors safe. The Infection Prevention Society recently contributed to revised IPC High Impact Interventions (currently out for consultation), which is updated guidance on reducing the risk of infection in healthcare settings.

Early intervention through infection prevention is cost effective and saves lives. We are calling on health providers in the UK to maintain investment in infection prevention to protect patients and finite NHS resources.

Dr Neil Wigglesworth is president of the Infection Prevention Society