On Tuesday 15th May, I participated in a Westminster Hall debate calling attention to the need for raising standards of infection prevention and control in the NHS. Specifically, I am concerned with the importance of hand hygiene in reducing healthcare associated infections (HAIs) and sort to highlight this with the Minister.
Hand hygiene is crucial because annually 5,000 deaths are caused from HAIs despite the World Health Organisation estimating over half of those deaths could be prevented through effective hand hygiene. If we have an opportunity to prevent 2,500 people dying unnecessarily each year though such measures, which are neither terribly difficult nor expensive, then it is time for action and to implement them.
The Secretary of State for Health announced that from 2017, hand gel usage would have to be monitored and reported to the Care Quality Commission (CQC), with data collection being managed by Public Health England (PHE). As yet there has been lack of clarity on the progress made to implement this policy and since the end of 2017 deadline for implementation has already passed this debate was a chance to reiterate the need for the Government to implement this strategy.
It is crucial that we have the processes in place that can identify when performance is slipping and then remind people, gently and constructively, how important hand hygiene is. The issue should not be framed as health service staff deliberately not cleaning their hands as often as they ought to. Rather it is a case of ensuring that in the high-pressure situations, behaviours which should not creep in, do not. Which is why we need accurate and sensible monitoring.
Current monitoring of hand hygiene compliance is inaccurate and infrequent. In fact, direct observation artificially inflates reported compliance as staff wash their hands more frequently when they know they are being monitored. So the question is where there is a better way of monitoring compliance and obtaining the data needed to see trends and whether they are reflected in infection rates.
The best alternative to current monitoring practices, is electronic and if the Government’s announcement of producing hand hygiene indicators by monitoring consumption of hand sanitisers is implemented in the right way, then it is an excellent opportunity to reduce rates of HAIs.
The Deb Group, a large employer in Amber Valley which produces hand hygiene gel and monitoring techniques, are clear that weighing or counting cartridges used in hospital sanitiser dispensers must factor in patient bed numbers and staffing levels in order to accurately show hand hygiene compliance levels. There are many other different ways of monitoring compliance, some monitoring at an individual level rather than a ward level. Whichever option is chosen, it is now time for the Government to ask hospitals to collect real-time, accurate data that can help drive behavioural change.
Indeed, two acute hospital trusts in England are currently piloting electronic monitoring technology. The CQC report for one trust directly quotes “innovative practice to increase hand hygiene, using the latest technology monitoring the use of alcohol sanitising gel” as an area of “outstanding practice”.
We have the right plan, an easy and relatively cheap measure, so it is time to put it in force and to task the CQC to ensure that hospitals are doing it. Then I hope we will not need to have the same debate in a couple of years as to why there are 2,500 preventable deaths from HAIs.
Responding to the debate, Minister for Health Stephen Barclay MP said: “As several Members recognised, hand hygiene plays a key role in infection prevention and control, in supporting patient safety and in our efforts to address antimicrobial resistance. … We will continue to embed hand hygiene practice and promote awareness of it in the NHS, not just through World Hand Hygiene Day but through debates such as this one.”
Following this debate, I look forward to seeing how and when this can be done.
You can read the full debate here.