Select Committee on Science and Technology Written Evidence

Memorandum by Professor A M Emmerson


  Infection control is well established in the UK with the majority of Acute Health Care Trusts following the guidance for hospital infection control in England, Northern Ireland and Wales highlighted in the "Cooke Report" of 1995. Nevertheless, the management of Hospital Acquired Infection (HAI) would be improved by a few simple innovations.


  The team usually consists of a Consultant Medical Microbiologist (CMM) and one or more well qualified and trained Infection Control Nurses (ICNs). Whilst the CMM is often a Member of the Royal College of Pathologists (MRCPath) he/she is often less qualified as an Infection Control Doctor (ICD) although he/she is often called upon to take the lead in Infection Control and act as the ICD. The Association of Medical Microbiologists (AMM) have published a job description for the ICD but do not specify how many sessions (WTE's) the CMM should do. I believe that the ICD should be given a contract with specified sessions, probably five or six, but only after he has been properly trained.

  The Hospital Infection Society, the PHLS together with the London School of Hygiene and Tropical Medicine (LSHTM) have put together a part time modular course for postgraduates (doctors, nurses and scientists) called the Diploma of Hospital Infection (DipHIC) which gives the candidate a very good foundation for controlling infection in hospitals. If the Department of Health could make this an essential requirement for a substantive post in Infection Control this would really strengthen the ICT.

  Likewise, the ICNs have very good training courses in Infection Control with a number of postgraduate diplomas and degrees up and running (Sue McQueen past Chairman of the ICNA can update).

  One of the main activities underpinning Infection Control is surveillance (information for action) and yet this function is still in its infancy, apart from two or three centres eg Northern Ireland and Wales where it is well developed. We implore Trusts to carry out surveillance and the DoH has made it mandatory to collect information on MRSA and bacteraemias; further work on elective orthopaedic surgery may follow. Yet again, we lack the resource to do this. As you are aware Sue and myself through SACAR raised the concept of setting up a Surveillance Officer to take the lead on this. Such a person could be a nurse/scientist but they can be trained to facilitate the collection of agreed surveillance data.

  I believe that the introduction of these simple innovations would make a substantial contribution to strengthening the ICT and thus improve the impact that Infection Control Staff will have in the prevention and control of HAI. I write these few comments as an individual (not as the President of the HIS, or as a SACAR member) but I have made my views available to the Chairman of HIS, Dr Bob Spencer and the AMM President, Dr Michael Kelsey.

  Both Sue McQueen and I would be willing to talk to you if this would help clarify some of these points.

October 2002

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