Understanding and avoiding infections in the community

Together Everyone Achieves More (TEAM):
Patient Partnership for Quality Care Seminar, October 12th 2011

The Royal Society of Medicine, London

Chaired by Lord Toby Harris


Following on from the event and report of Lord Toby Harris "Tackling Transmission of Healthcare-Associated Infections 2010" the alliance of patient groups and charities - TEAM (Together Everyone Achieves More) came together to refocus on the four key themes that came from the report.  Firstly, that wide-ranging education is important, particularly for those coming into the National Health Service for the first time.  It is equally important that patients have an education as well as clinicians. The second theme was that engaged patients are partners in their own healthcare strategy, in their own healthcare safety; it is important that they realize that. The third theme was disease-specific awareness being a top priority and that patient groups have a major role to play in this. The fourth key point reached was that we must maintain progress, particularly on reducing MRSA and C. difficile while extending action against other and emerging pathogens.



Event chaired by Lord Toby Harris 2010


Professor Brian Duerden and Janice Stevens revisited where we had come from and reviewed emerging infections in the community.  Ginny Edwards focused on the emerging role of Health and Wellbeing Boards and HealthWatch with respect to infections in the community.  There are potential activities for TEAM to connect and work with HealthWatch and the new NHS and Social Care architecture to prioritise the delivery of clean, safe community environments.


Helen Bronstein attended from MRSA Action UK and we submitted a paper to be included in the report.  Summary of MRSA Action UK's position statement on understanding and avoiding infections in the community:


There needs to be more effective action in the primary care setting and in the community to mirror the efforts and success we have seen in programmes to reduce infections in hospital.


We need action to preserve the golden bullets - antibiotics, if we don't want to be in the same position as earlier generations when there were none.   Expertise in antibiotic prescribing needs to be made use of in the GP surgery, and patients should expect to be advised on the judicious use of antibiotics, and when they are not needed.  Making sure the correct antibiotic for the condition is used is vital if the development resistance is to be avoided. 


We need to make better use of the information that we collect and publish it more widely, patients want information and have a right to know about risks from infections, there should be more data on surgical wounds, catheter and bloodstream infections caused by other pathogens.


Post discharge care and advice on infection prevention is vital. From the experience of patients and families contacting us, not enough attention is given to screening if a patient has had a healthcare associated infection, and this can be key in identifying the need for further treatment to make sure an infection does not reoccur, which can then become resistant to antibiotic therapies and more difficult to treat.


Supporting staff in Care Homes with training and making sure there is information sharing between providers needs to be improved.  We need the help of regulators and policy makers to help Care Homes meet their obligation in The Health and Social Care Act 2008 - Code of Practice on the prevention and control of infections and related guidance.  Guidance for Care Homes has still not been published.


Supporting people at home is essential if we are to combat the existing and emerging threats of antibiotic resistance, it's not just the sick that are at risk and we believe an information campaign is long overdue.  We need to disseminate information on the relatively simple precautions we can take in the home, particularly to those people looking after their relatives after leaving hospital, and those who look after people with long-term conditions.


The regulators need to work with the patients and the patient groups on the development of guidance. One day all of us will at some time be the customer of the NHS, how confident can we be with the standard of care provided by our local NHS Trust?


The CQC published findings from the 2010 NHS Staff Survey that backs up the need for investment in training on infection prevention and control.  Only 70% of hospital staff said they had received infection control training in the last 12 months, and a staggering 35% in Primary Care Trusts.  The survey also revealed some other worrying findings, only 67% of hospital staff said hand-washing materials are always available when they need them, compared to 68% of staff in Primary Care Trusts.  Only 63% of hospital staff agreed with the statement "If a friend or relative needed treatment, I would be happy with the standard of care provided by this Trust".  For Primary Care Trusts even fewer staff agreed with the statement at 55%.


We should be under no illusion that our work is done either in hospital or the community when those who work in healthcare tell us they are not equipped to do their job.  The value and role of third-sector organisations in raising awareness and providing information for tackling infections in the community through the work of the TEAM partnership should not be underestimated and we should help the regulators in ensuring organisations are empowering staff and patients to deliver safe care.

If you or someone you care about has been affected by a healthcare infection and you wish to discuss this with us, please contact us at info@mrsaactionuk.net