Friday 10th February 2012 10am - 1.00 pm

NICE Office, Manchester

Maria Cann attended the NICE Topic Selection Workshop, which brought together a range of stakeholders with knowledge, experience and expertise in the prevention and control of healthcare associated infections. During the work on preparing the guidance for use in the primary care setting a range of areas where further guidance may be needed was identified, stakeholders came together at the workshop in Manchester to take suggested topics for further guidance further.

Dr Alan Maryon Davis independent chair of NICE public health topic selection, introduced the workshop. Dr Davis is also known for his work as an author in areas of public health and well being, and an expert guest on TV and radio, he is an honorary professor in public health at Kings College London and was the inaugural chair of the Royal Society for Public Health in 2008/09.

Jane Huntley, Associate Director, Centre for Public Health Excellence NICE, gave an overview of the process.

Topic selection is the process used to identify and prioritise which approaches to the promotion and protection of health and the prevention of ill health should be the subject of NICE guidance.

It is important that topics are relevant and timely, and that they address priority issues that will help to improve the health of the population. The topic selection process also ensures that the selection of public health and clinical guidance topics is coordinated.

NICE considers topic suggestions from a range of sources including local authorities, schools, the NHS, the voluntary sector and the general public. Anyone may suggest a topic for NICE guidance

In addition, NICE searches for topics by organising regular workshops to discuss ideas for potential guidance topics.

The topic selection process considers the suggestions to see if they are within NICE's remit, these are then filtered according to the selection criteria set by the Department of Health. 

A detailed briefing paper for each selected topic is prepared together with findings from a literature search are used to support the briefing paper.

The Public Health Topic Selection Consideration Panel considers the briefing paper and prioritises the topic in terms of its overall importance for public health and carries out an internal check to ensure that the proposed clinical and public health topics integrate well and do not overlap. 

The sets of clinical and public health topics are considered by the Department of Health.

Ministers make the final decision on which topics to refer to NICE.

Professor Bharat Patel, Consultant Medical Microbiologist / Health Protection Agency Microbiology Services and HCAI Lead for London, set the scene with his presentation on how far we had come in terms of prevention and control of healthcare associated infections and what the continuing threats were, with 20 billion pounds coming out the system there was a need to make the best use of resources to improve patient care and to reduce the deficit caused by avoidable healthcare infections.

Following this a number of potential areas for new guidance were discussed and explored and will form the initial stage of the scoping for further investigation, these included

- HCAI surveillance in community and care settings

- Cleaning (hospital and other care settings)

- Post-discharge surveillance, and reducing readmission rates 

- What was the most effective and cost effective way of improving and promoting hand hygiene in all settings where healthcare is practised - and the use of the behavioural tool developed by the IPS and Hand Hygiene Alliance of patients and healthcare workers

- Promoting good antimicrobial stewardship / good antimicrobial prescribing practice in a range of settings (including community pharmacy) - raising awareness with the public

- Spatial planning and management to produce cleaner healthcare buildings

- Device and catheter care, in primary settings in particular

- Information sharing between hospital, primary care and patient information (making use of good practice that has been developed, and making this the standard practice) - this linked with information dissemination in general, for example a Chief Executive saying his hospital has no MRSA may not be meant to be deliberately misleading, but it's his understanding of the situation - the Department of Health saying hospitals have no MRSA is a different matter however, no bacteraemias is great, but its poor judgment to ignore the many other infections caused by this organism. 

There are pieces of research and evidence that show the benefits of providing better information, and this means educating staff at all levels in some of the fundamental facts.  Education and information were broadly recognised by the group as being a topic that merited taking forward.

Avoiding unnecessary visits to the doctor, A&E and calls to the emergency services through accessing inappropriate information was also something our group discussed.