Recommendation 106

Healthcare associated infections surveillance

Accepted
The Health Protection Agency and its successor, should co-ordinate the collection, analysis and publication of information on each provider‘s performance in relation to healthcare associated infections, working with the Health and Social Care Information Centre.

Public Health England (PHE), which since April 2013 has taken on the functions of the Health Protection Agency, is working together with the Health and Social Care Information Centre (HSCIC) to coordinate the collection, analysis and publication of information in relation to Healthcare Associated Infections (HCAI).

This includes a number of on-going activities: exploration of linkage of PHE HCAI patient-level surveillance data with Hospital Episode Statistics data for enhanced epidemiological analyses; exploration of linkage of PHE HCAI surveillance data with the death registrations (for mortality trends) to improve understanding of causality; PHE facilitation of voluntary surveillance within the Infections in Critical Care Quality Improvement Programme to increase the knowledge and evidence base, leading to quality improvement; a review of priority categories for Surgical Site Infection surveillance to inform strategic development and support needs of local users; taking a key role in the finalisation, roll-out and on-going development of the new Data Capture System to incorporate and support the above-mentioned surveillances activities. PHE is also working with trusts and CCGs to facilitate the Post Infection Review process for MRSA.

Additionally, PHE is providing advice and support to the Care Quality Commission in its regulatory work to develop its new surveillance model for the construction of quality indicators.

Update

Public Health England publishes as routine mandatory surveillance data on Meticillin-resistant Staphylococcus aureus (MRSA), Meticillin-sensitive Staphylococcus aureus (MSSA) and Escherichia coli (E. coli) bloodstream infections and Clostridium difficile infection (CDI) at the level of each NHS acute trust. Trusts report these data to a web-based data capture system. Public Health England is providing expertise to support the development of a new integrated and future-proofed data capture system for its mandatory healthcare associated infection surveillance programmes which can be used by all parts of the healthcare system.

Public Health England also provides expertise to support NHS organisations reporting positive cases of Meticillin-resistant Staphylococcus aureus bloodstream infection in undertaking a Post Infection Review for each case. A Post Infection Review is undertaken to identify how a case occurred, actions which can prevent a reoccurrence and the organisation best placed to ensure improvements are made. Public Health England has successfully liaised with NHS England to refine the Post Infection Review process from April 2014 so that cases of Meticillin-resistant Staphylococcus aureus bloodstream infection can be more accurately assigned to either an acute trust, Clinical Commissioning Group or ‘third party’ acknowledging the complex nature of cases.

In order to assess patient outcomes, Public Health England has successfully linked data both on bloodstream infections and surgical site infection (hip replacement and other types of surgery) to the Office for National Statistics death registration data Before the end of March 2015, Public Health England will assume responsibility for producing mortality data for cases of Meticillin-resistant Staphylococcus aureus bloodstream infection and Clostridium difficile infection by linking Public Health England mandatory surveillance data with death registration data. This data will be published on an annual basis.