Agenda item

Report of the Director of Public Health

The Director of Public Health submitted a report (previously circulated) explaining what healthcare-associated infections (HCAIs) are, how they occur, and the key measures used to prevent them and how infections spread within healthcare environments. The submitted report also sets out the roles of the organisations responsible for preventing and managing HCAIs and outlines some of the work taking place locally in relation to HCAIs. A presentation (also previously circulated) accompanied the report.

It was reported that HCAIs remain a preventable risk across health and care setting; that reducing these infections depends on consistent application of key infection-prevention measures; and that tackling HCAI’s requires coordinated action across national, regional and local systems.

The submitted report outlined the system responsibilities in relation to infection prevention and control (IPC), with NHS England providing national leadership by setting IPC standards, monitoring provider performance and analysing surveillance data supplied through the UK Health Security Agency’s (UKHSA) mandatory reporting systems

Details were provided of the role of the UKHSA in the prevention and control of HCAIs across England, with Members noting that at a local level, support is provided to NHS trusts and local authority health teams through the North East Health Protection Team.

It was reported County Durham and Darlington NHS Foundation Trust has an agreed framework for preventing and managing HCAIs; that the Trusts Quality Accounts sets clear infection-prevention priorities; and that the Trust has governance arrangements in place and works closely in collaboration with partners across the wider health and care system to ensure the infection-prevention activity is aligned across organisations.

Reference was made to the statutory responsibility of the local authority to protect and improve the health of its population; that the local authority maintains oversight of local health protection arrangements and ensures that appropriate systems are in place across community settings including care homes; and in order to maintain oversight of infection-prevention standards, the local authority draws on a range of intelligence, including CQC inspection outcomes, local surveillance data, outbreak

reports and feedback from providers, residents and the public.

A presentation provided figures for NHS antibiotic consumption and antimicrobial resistance for CPE, MRSA, MSSA and C.difficile infections for 2025/26; and Members were provided with details of CDDFT’s actions to reduce HCAI’s, with particular reference made to examples of collaborative working to address CPE outbreaks. Members were also provided with details of the work undertaken in relation to antimicrobial stewardship, including a rolling programme of audit compliance, reducing the use of high risk antibiotics and education of staff.

Discussion ensued regarding the risk assessment approach in relation to bathing, with Members being assured that these were based on the individual; that in relation to MRSA infections, Executive-led patient infection reviews have been implemented for all bloodstream infections and that policy had been changed to introduce universal screening to allow early identification of infections, which will inform future targeted screening approaches.

Members requested further information regarding the impact of HCAI of CPE within care home settings; and further discussion ensued regarding the learning from the CPE outbreak within the Trust. Members noted that audits had previously shown poor compliance in relation to infection prevention control, including handwashing and that this has been addressed over a three-year period through direct conversations and continued engagement with staff in relation to their roles and responsibilities and expectations regarding the Trust’s policy for hand hygiene. External auditors have also supported this process and the Trust continues to undertake validation audits.

Following a question, Members were advised that work was being undertaken nationally by a group of specialists to help inform the NHS new hospital programme; this included a review of risks associated with wastewater, drainage and ventilation.

Further discussion ensued regarding CPE with Members being advised that discharge summaries would include information for those patients identified as carrying CPE and the patient would also be informed, however no further actions are required by care homes beyond usual IPC practice; and in relation to the ward refresh, the work is ongoing and will take place over a period of time, to manage the financial and logistical requirements.

RESOLVED – (a) That the contents of the report and the range of local and national responsibilities for preventing and managing HCAIs, be noted.

(b) That the complex nature of HCAIs and the multi-layered system of organisations involved in their prevention and control be recognised.

(c) That the significant work and actions already undertaken across the system, including by the local authority, ICB, UKHSA and County Durham and Darlington NHS Foundation Trust, to reduce HCAI risks be acknowledged.

(d) That Members continue to seek assurance through Quality Accounts, regular surveillance reports and routine updates from system partners on ongoing infection-prevention performance.