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Infection Control in General Practice

Infection control is one of the major areas in the provision of safe care within any health care setting. It is also one of the priorities in any CQC inspection under Regulation 12 of the, Safe care and treatment, of the Health and Social Care Act 2008. There is a need for practices to be compliant with regulations and it is worth reading the following documents as they are the ones practices will be assessed against by CQC.

CQC

The CQC will except each practice to have: -

CCG Support

It is advised that practices make contact with the IC leads at the CCG for up to date advice and guidance on IC, for example West Hampshire CCG have an excellent website.

Sepsis

All staff in general practice should be aware of how to detect signs of deterioration and sepsis in patients and it is an area that the CQC will ask questions. This link to our Wessex LMCs Lunch & Learn can be shared with the whole practice team to improve awareness and management of sepsis and deterioration.

Legionnaire

Legionnaire's Disease is a potentially deadly disease caused by the legionella organism. The organisms can live in water systems used for air conditioning, showers, and cooling systems. Like with all the other risk assessments practices make on a regular basis, it should be a consideration but there is no mandatory requirement* or system for this so far.

*Legal point of clarification - there is no mandatory requirement to employ an agency to do a legionella risk assessment. The need for practices to do a "suitable and sufficient" risk assessment is covered under the Health and Safety at Work Act 1974 section 4 (duties of Landlords and those in control of premises). To comply with this act there is a need to (among other things) take account of the approved HSE code of practice L8

This leaflet Legionnaire's Disease - a guide for employers , produced by the HSE (Health and Safety Executive) is informative and will enable most practices to feel confident that they know enough to make a reasonable judgement and risk assessment.

(Taken from West Hampshire CCG - Water Safety (Legionnaires' Disease) in Primary Care)

Primary Care practices have a duty to ensure that their water systems do not pose a risk to the health and safety of employees and visitors (e.g. patients, hosted staff and contractors) from Legionella bacteria under the Control of Substances Hazardous to Health Regulations (COSHH) and the Health & Safety at Work Act.

The Care Quality Commission (CQC) also expects practices to fulfill these obligations to demonstrate compliance with the essential standards of quality and safety (Outcome 8: cleanliness and infection control and Outcome 10: safety and suitability of premises).

All water systems in Primary Care practices require a risk assessment. However not all systems will require elaborate control measures and responses and actions should be proportionate to the identified risk. A simple risk assessment may show that the risks are low and being properly managed to comply with the law. It is likely to that most practices will not require anything more than a basic local risk assessment and simple in-house control measures.

This document (Water Safety Pseudomonas and Legionella v3.pdf [pdf] 405KB) is a summary designed to introduce Primary Care practices to the requirements around water safety and help practices determine whether external consultation is proportionate and necessary.

Please also use this link to the Wessex LMC .

Useful Web Links

Infection Control

  

Health and Social Care Act 2008. Code of practice on the prevention and control of infections and related guidance.

https://www.gov.uk/government/publications/the-health-and-social-care-act-2008-code-of-practice-on-the-prevention-and-control- of-infections-and-related-guidance

Infection Prevention and Control Commissioning Toolkit 

https://www.rcn.org.uk/professional-development/publications/pub-005375  

Royal College of Nursing - Infection Prevention and Control - Subject Guide   

https://www.rcn.org.uk/library/subject-guides/infection-prevention-and-control-subject-guide

Royal College of Nursing - Infection Prevention and Control - Clinical Topics

https://www.rcn.org.uk/clinical-topics/infection-prevention-and-control

Audit Tool

Infection Prevention Quality Improvement Tools. GP Surgery/Health Centre

https://www.rcn.org.uk/professional-development/publications/pub-005375

Useful Resources, Information and Advice on Training

Infection Prevention Control - CQC Compliance

https://www.infectionpreventioncontrol.co.uk/cqc-compliance/ and   https://www.infectionpreventioncontrol.co.uk/

e-Learning for Healthcare

https://www.e-lfh.org.uk/

Legionnaire

CQC Regulation 12: Safe Care and Treatment

https://www.infectionpreventioncontrol.co.uk/cqc-compliance/

West Hampshire CCG - Useful resources for Healthcare Professionals

https://www.westhampshireccg.nhs.uk/useful-resources

PHE - Legionella: Detection in Healthcare Premises

https://www.gov.uk/government/publications/legionella-detection-in-healthcare-premises

BMA - Focus on Legionella Control (BMA Dec 2018)

https://www.bma.org.uk/advice/employment/gp-practices/premises/focus-on-legionella-control

Controlled Substances Hazardous to Health (COSHH)

HSE - Control of Substances Hazardous to Health (COSHH)

http://www.hse.gov.uk/coshh/

Waste Management

CQC - Nigel's Surgery 76: Health Care Waste

https://www.cqc.org.uk/guidance-providers/gps/nigels-surgery-76-health-care-waste

NHS England - Clinical Waste Services for GPs and Pharmacies 

https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/05/clncl-waste-factsht.pdf

Department of Health - Safe Management of Healthcare Waste

(Information specific to General Practice can be found on pages 141-145 of this link) 

https://www.gov.uk/government/publications/guidance-on-the-safe-management-of-healthcare-waste

NHS England - Best Way to Wash Your Hands (Page last reviewed: 29/09/2016. Next review date 29/09/2019)

https://www.nhs.uk/live-well/healthy-body/best-way-to-wash-your-hands/

Hand Hygiene Policy for General Practice

https://www.infectionpreventioncontrol.co.uk/resources/hand-hygiene-for-general-practice/

 

MPS

Medical Protection - Risk Alert: Infection Control

https://www.medicalprotection.org/uk/articles/risk-alert-infection-control

Needle Stick Injury

What should I do if I injure myself with a used needle? 

https://www.nhs.uk/common-health-questions/accidents-first-aid-and-treatments/what-should-i-do-if-i-injure-myself-with-a-used-needle/

Sharps Injuries   

http://www.hse.gov.uk/healthservices/needlesticks/

Zika virus (ZIKV): clinical and travel guidance 

https://www.gov.uk/government/collections/zika-virus-zikv-clinical-and-travel-guidance

Antimicrobial Stewardship

Antimicrobial stewardship: prescribing antibiotics 

https://www.nice.org.uk/advice/ktt9

Managing Common Infections

Managing common infections: guidance for primary care  

https://www.gov.uk/government/publications/managing-common-infections-guidance-for-primary-care

Managing common infections: guidance for primary care  https://www.gov.uk/government/publications/managing-common-infections-guidance-for-primary-care

Prescribing Antibiotics

Antibiotic Prescribing in the Community  

https://www.wessexlmcs.com/antibioticprescribinginthecommunity

NHS Antibiotic Guidelines for Primary Care  

http://www.nhsantibioticguidelines.org.uk/

Patient Resources

NHS Wales - Treating your infection

http://www.wales.nhs.uk/sitesplus/documents/888/Treating%20your%20infection%20EAAD%20leaflet%20%28English%29.pdf

Managing your infection

http://www.wales.nhs.uk/sitesplus/documents/888/Treating%20your%20infection%20EAAD%20leaflet%20%28English%29.pdf

 

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Updated on 20 September 2019 1193 views