NHS Backlog – Where Are We Now?

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A couple of years ago, we analysed the NHS backlog, including some of its underlying causes, along with the plans in place to address it. More recently, we assessed the current state of A&E waiting times across the NHS.

The UK now has a new Labour government. The 2024 Labour manifesto promised to “build an NHS fit for the future.”

In this post, we’ll look at the current state of the NHS backlog and explore Labour’s plans for addressing these challenges.

What is the NHS Backlog?

They define the backlog as “the care the NHS would normally have delivered, but which was disrupted as COVID-19 impacted service delivery”. This incorporates cancelled procedures, delayed or refused referrals, and patients on waiting lists for treatments who would ordinarily have been seen by now.

The BMA also recognises “patients who have not yet presented to the GP… due to concerns of burdening the health service…” This implies that it’s impossible to measure the full extent of the lockdown. There’s a “hidden backlog” to contend with, too.

NHS Backlog in 2024 – What Does It Look Like Right Now?

According to the latest BMA figures, more patients than ever are currently waiting for treatment. In May 2024, there were a total of 6,377,599 individual patients waiting for treatment in England alone. Almost half of these patients have been waiting for over 18 weeks, and over 300,000 have been waiting for over a year.

The BMA regularly updates their figures on the NHS backlog.

Long-Term Issues and Brand-New Challenges

The backlog can still be largely attributed to the immense disruption brought by COVID-19 and the associated lockdowns. Yet even before the pandemic struck, demand for hospital treatment was outstripping capacity.

The NHS has a long-term plan of ensuring that 92% of patients should receive treatment within 18 months of referral. The last time this target was met was in September 2015.

To make matters worse, in July 2024 a global IT outage plunged many industries into chaos. This affected many healthcare services, with GP practices warning that they’re now facing a “considerable backlog” in appointments.

The New Labour Government’s Plans For the NHS

In their election manifesto, Labour outlined their plans for the NHS as follows:

  • Cut waiting times with 40,000 more appointments each week.
  • Double the number of cancer scanners.
  • A new Dentistry Rescue Plan.
  • 8,500 additional mental health staff.
  • Return of the family doctor.

Referencing the NHS backlog, the manifesto said:

“We will return to meeting NHS performance standards. That means patients should expect to wait no longer than 18 weeks from referral for consultant-led treatment of non-urgent health conditions. This standard was achieved with the last Labour government and will be again under the next.”

Here’s how Labour plan to achieve these goals:

  • Incentivising staff to carry out additional appointments out of hours.
  • Pooling resources across neighbouring hospitals to introduce shared waiting lists to allow patients to be treated quicker.
  • Using spare capacity in the independent sector to ensure patients are diagnosed and treated more quickly.
  • “Reset relations with NHS staff” to address treatments affected by staff strikes.

What are the New Government’s Targets for the NHS Backlog?

Labour’s target is to clear the waiting time for elective treatment of over 18 weeks within five years. Analysis in the BMJ has outlined the practical, political, and financial considerations that will be necessary for Labour to achieve this target.

“Short of achieving near miraculous improvements in economic growth,” the report says, “the stark choices over NHS funding will have profound implications for the incoming government’s entire programme.”

We have already seen one of Labour’s policy pledges in action: The plan to draw from spare capacity in the independent sector to diagnose NHS patients. Since April, the Sussex Elective Co-ordination Centre has been helping over 400 NHS patients a week access private care facilities.

Yet at the time of writing, the new Labour government has been in place for less than a month. Obviously, it is still far too early to assess their success in clearing the NHS backlog. The BMA figures suggest that things are as bad as they’ve ever been. Yet hopefully, things can only get better.

Support For NHS Healthcare Providers

At Cairn Technology, we specialise in improving quality and efficiency in healthcare settings.

While we cannot help you address long waiting lists in your NHS healthcare setting, we can help you to improve staff safety and well-being while reducing turnaround times between certain procedures.

For a friendly chat about how we can help you, get in touch to talk to one of our experts today.

How Long are A&E Waiting Times in the UK – Where Are We Now?

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A few years ago, we explored the NHS backlog, and its underlying causes. We also assessed the NHS targets for clearing these backlogs, and discussed the impacts they were having on ambulance waiting times.

In this post we’ll take a closer look at the current state of A&E waiting times in the UK, and how they compare to pre-pandemic levels.

All of the figures and trends we refer to in this post come from this Office for National Statistics report.

A&E Waiting Times Vary Across the UK

Across the UK home countries, you will find slightly different policies on how A&E wait time data is collected. It’s possible to make broad comparisons between A&E wait times between England, Scotland, and Wales. However, Northern Ireland’s healthcare data collection policy differs so much as to make comparisons more difficult.

But that said, we can compare data on the overall number of A&E attendances across all four countries.

NHS Targets for A&E Waiting Times

Every country in the UK aims for a four hour standard for A&E visits. The general aim is that at least 95% of attendances will be admitted, transferred, or discharged within four hours of arriving at A&E.

Following the pandemic, the NHS was under considerable pressure as services struggled to deal with patient backlogs. So, in December 2022, NHS England implemented a new temporary standard, whereby they would aim to see at least 76% of A&E attendances within four hours. NHS England returned to the 95% four hour standard in March 2024.

What is the 12 Hour Waiting Time Standard?

In addition to this four hour standard, Wales and Northern Ireland have a 12 hour standard. The aim here is that no patient should have to wait longer than 12 hours in any type of A&E department.

Average A&E Waiting Times Are Getting Longer

Across the UK, between 2013 and 2023, there has been an overall rise in the monthly percentage of A&E attendances waiting longer than four hours. Patients in England have seen the biggest rise in A&E waiting times. In January 2013, 8.1% of attendances waited longer than four hours. By September 2023, this figure had risen to 42.4%.

December 2022 saw a peak in A&E waiting times across England, Scotland, and Wales. In this one month, 50.4% of English patients, 41.7% of Scottish patients, and 45.8% of Welsh patients had to wait longer than four hours to be seen.

A&E wait times dropped significantly during the early months of the pandemic. Lockdown restrictions meant that fewer people overall attended A&E departments. While this contributed to a drop in A&E wait times, it would later result in a huge backlog of care. This is partially why wait times rose significantly in the years following the pandemic.

Why Are A&E Wait Times Getting Longer?

Beyond the post-pandemic backlog of care, there are other explanations for the rise in A&E wait times across all four UK countries.

These include:

  • Population Changes – As populations have grown, so too have the proportion of A&E attendances per 1,000 population. A growing population may also be associated with a growth in rates of disability, or long-term illnesses, that might necessitate an A&E visit.
  • Aging Populations – A higher proportion of elderly people in a population means a higher proportion of the age-related injuries and illnesses.
  • Ease of Access – In some parts of the country, people may struggle to access certain healthcare services. For example, the lack of healthcare provisions in rural areas might increase A&E attendance rates in nearby towns and cities.
  • Policy Changes – We have already explored how lockdown policies might have influenced A&E wait times. In addition to this, governments across the UK have imposed other policies that may have impacted A&E wait times, such as Scotland’s efforts to discourage unplanned attendances.

How to Find A&E Waiting Times Near Me

If you want to find out how long you might have to wait to get seen at healthcare providers in your area, use this NHS Tracker resource on the BBC’s website.

Enter your postcode and it will give you an idea of:

  • Ambulance waiting times
  • A&E waiting times
  • Treatment waiting times

Support For NHS Healthcare Providers

At Cairn Technology, we specialise in improving quality and efficiency in healthcare settings.

While we cannot help you address long waiting lists in your A&E department, we can help you to improve staff safety and well-being while reducing turnaround times between certain procedures.

For a friendly chat about how we can help you, get in touch to talk to one of our experts today.

Nitrous Oxide in the NHS – Risks, Plans, and Targets

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For years, the NHS made extensive use of nitrous oxide as an anaesthetic gas. Yet there are concerns that prolonged exposure to nitrous oxide could pose certain health risks. Practitioners are also becoming increasingly aware of the possible environmental impact of using anaesthetic gases.

How is Nitrous Oxide Used in Healthcare

Nitrous oxide is an odourless and colourless gas. In sub-anaesthetic concentrations it acts as a powerful analgesic. It is most commonly used in a 50:50 mix with oxygen. This mixture is otherwise known as “gas and air”, or Entonox.

Nitrous Oxide Health Risks

Short-term exposure to Entonox can cause dizziness, fatigue, and nausea. Long-term exposure can affect the body’s capacity to absorb vitamin B12. This can damage the body’s nervous system and red blood cells, which can lead to a number of neurological conditions.

Prolonged exposure to nitrous oxide may also increase the risk of developing certain liver and kidney diseases.

The exposure risks for patients are low, as patients inhale the gas through a demand valve. However, when they breathe out, they can release some of the nitrous oxide back into the room. Over time, this can create an exposure risk for medical personnel. The risk will be greater if there are ever any gas leaks, or if staff routinely administer the gas in a poorly ventilated area.

This is why it’s essential to monitor the levels of nitrous oxide in hospitals. Our workplace exposure monitoring servicecan help you address your staff’s exposure to nitrous oxide and other potentially harmful substances.

Nitrous Oxide Environmental Risks – And The Solution

In a 2022 report, the NHS discussed the environmental impact of using certain anaesthetic gases. They revealed that emissions from one bottle can produce the same amount of carbon as burning 440kg of coal.

The NHS’s long-term plan is to reduce the carbon footprint associated with anaesthetic gases by 40%. Part of this strategy involves switching to lower carbon alternatives, such as sevoflurane.

The NHS is also exploring techniques for capturing, destroying, or reusing anaesthetic gases. They estimate that capturing and destroying nitrous oxide could cut over 33% of their total anaesthetic emissions.

There’s also a focus on cutting down on nitrous oxide wastage. Up to 30% of nitrous oxide may remain in cannisters after use. This residual gas can carry an environmental risk if it leaks, and recycling or reusing it can prove difficult.

We Can Help You Address The Risks of Nitrous Oxide in Your Hospital

Nitrous oxide leaks in your hospital contribute to your overall carbon footprint, and they may also present long-term workplace exposure risks for your personnel.

Keeping on top of equipment maintenance can help prevent leaks. It’s also important to ensure that any area of your hospital where nitrous oxide or other anaesthetic gases are administered is as well-ventilated as possible.

Yet if you want to address the exposure risks in your hospital, first you will need to understand the risks. This is where we can help. Our workplace exposure monitoring service can help you address your staff’s exposure to nitrous oxide and other potentially harmful substances.

We can provide a comprehensive report including discussions and recommendations based upon our findings. In this way, we can help you meet your COSHH obligations wherever your staff are exposed to hazardous substances in your hospital.

For information on our workplace exposure monitoring services, give us a call on 0845 226 0185 email us at info@cairntechnology.com

Greenwashing in Healthcare – How to Take Effective Action

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In recent years, growing numbers of healthcare providers have been accused of “greenwashing”.

In this post we’ll explore what greenwashing in healthcare is, and what it looks like. We’ll also explore some ways you can ensure your environmental performance delivers in practice, and not just on paper.

What is Greenwashing?

“Greenwashing” essentially means that there’s a disconnect between your environmental policies and your environmental practices. It means that you might describe your services and your operations as environmentally responsible and sustainable, when in reality your practices are not nearly as green as they seem.

Why Does Greenwashing Happen?

Greenwashing isn’t always intentional. Sometimes it can happen by accident, when managers overlook certain processes, or when staff members or service users do not properly follow certain procedures.

But increasingly, people want to know that the services they use are taking steps to address the environmental impact of their operations. So if you claim to be green, then you must ensure you deliver on your promises. Otherwise, you could be misleading the public. And in healthcare settings, overlooking the environmental impact of certain processes can also carry some health risks.

What Does Greenwashing Look Like in Healthcare?

Your healthcare setting might set an environmental policy, and you might make certain declarations, and set certain aims, in your internal documents and communications. You might also communicate your environmental goals to your staff and patients, via onsite posters, leaflets, brochures, and even press releases.

If your environmental impact does not meet the standards you set in these materials, then you might be accused of greenwashing.

Examples of Greenwashing in Healthcare

How Can Healthcare Take Effective Environmental Action?

The need for effective infection prevention and control can make going green particularly challenging for healthcare settings. For example, how can a hospital commit to reducing waste when the Standard Infection Control Precautions advise using single-use items as often as possible? How can a care home embrace recycling when PPE best practice often advises disposing of items immediately after use?

The answer – and it is by no means an easy one – is to review all of your operations, from start to finish, and look for any areas where you might make any improvements to your environmental performance. And you need to do this without compromising on your operational efficiency, or your infection prevention and control processes.

Once you have reviewed your processes and established some possible areas of improvement, you need to communicate these to all staff at all levels. Your staff will be accustomed to doing things in a certain way. They might need some additional training if they need to get used to a greener way to complete a certain process.

Case Study – The Green Theatre Checklist

For some examples of how healthcare teams can improve their environmental performance without compromising on care standards or safety, take a look at the Green Theatre Checklist. This is a set of guidelines for how operating theatre teams can address their carbon footprints and work towards sustainability in surgery.

It recommends actions for every stage of surgery, from anaesthetic care to postoperative. Guidelines include:

  • Sourcing materials as locally as possible, to cut down on carbon emissions during transit.
  • Using “greener” substances wherever possible, such as sevoflurane instead of isoflurane.
  • Switching to reusable equipment wherever possible. Your PPE may always have to be single-use. But other equipment, such as underbody heaters, slide sheets, and trays, can be reusable.
  • Minimise waste. For example, follow a policy of “don’t open it unless you need it” when it comes to drugs and single-use equipment.
  • Reduce your water and energy consumption. This could include switching to automatic or peddle controlled taps. And when it comes to hand hygiene, adopt a “rub not scrub” approach: A water scrub to start the day, and alcohol rub for all subsequent procedures.

You can access and download the full Green Theatre Checklist.

Case Study – “Toxic Air at the Door of the NHS.”

The Toxic Air at the Door of the NHS report revealed that over 2,000 UK health centres are located in areas where the atmospheric concentration of particulate matter exceeds the World Health Organization’s recommended limits. This accounts for around 25% of all hospitals in the UK.

Particulate matter – including PM2.5 and PM10 – is a hazardous air pollutant that can contribute to, or worsen, a number of health conditions when inhaled. Road traffic is a major source of particulate matter. According to one study, over 20,000 respiratory and cardiovascular hospital admissions each year can be linked to air pollution.

Hospitals and healthcare settings might address this problem through setting strict onsite speed limits, and through banning smoking on the premises. Though as we suggested earlier, unless you also take measures to address the air quality inside your healthcare setting, then you might reasonably be accused of greenwashing.

There are two strategies you can adopt to improve the onsite air quality throughout your setting:

We Can Help You Deliver On Your Environmental Policies

At Cairn Technology, we can advise on switching to products and services that will help you cut down on unnecessary waste without compromising on your infection control or your operational efficiency.

We have a wide selection of reusable high-quality surgical instruments. Make the switch from single-use instruments and help to cut down on the waste associated with their mass production and disposal.

Take a look at our super absorbent floor mats, which cut down on the waste associated with higher volume production and waste of mats with much lower absorbency, such as inco pads.

We can also provide specialist air quality monitoring services.

Get in touch with our friendly team of expert consultants to discuss your requirements today.

Health and Wellbeing and Indoor Environmental Quality in Buildings – A Guide to BS 40102-1:2023

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BS 40102-1:2023 – Health and Wellbeing and Indoor Environmental Quality in Buildings is a new code of practice which launched in April 2023.

In this post we’ll explain what BS 40102-1:2023 entails and discuss how you can meet the new regulations in your workplace.

What is BS 40102?

This new code of practice outlines a monitoring and reporting strategy for assessing wellbeing and indoor environmental quality (IEQ) of non-domestic buildings. It establishes a rating system for benchmarking the quality of the:

  • Air
  • Light
  • Thermal comfort
  • Acoustics and soundscape

With these benchmark scores, facility managers can identify any problematic areas and make any necessary improvements.

BS 40102 applies to all forms of non-domestic buildings, existing or new.

Why Has ‘Health and Wellbeing and Indoor Environmental Quality in Buildings’ Been Introduced?

The BSI Group acknowledges that previous regulations, coupled with certain commercial pressures, encouraged designers, builders, and facility managers to prioritise energy efficiency. All too often, a focus on energy efficiency means that the health and wellbeing of a building’s occupants gets overlooked. For instance, a building might be constructed with efficient insulation, but with little thought given to the quality of ventilation and light levels.

These new standards will help facility managers and others improve the IEQs of the buildings they oversee. Improving IEQ can help reduce operating costs through increasing energy efficiency. But for hospitals and other healthcare settings, addressing IEQ can help improve staff and patient health and wellbeing while contributing to infection prevention and control.

BS 40102 Air Quality Standards

When it comes to air quality, BS 40102 outlines rating systems for:

Example Indoor Environmental Quality Benchmarks

Below are the BS 40102 rating systems for two forms of particulate matter – PM2.5 and PM10.

PM2.5

Level Description 24 Hour Average (μg/m3)
0 Very High ≥32
1 High 16 – <32
2 Acceptable 10 – <16
3 Low 5 – <10
4 Very Low <5

 

PM10

Level Description 24 Hour Average (μg/m3)
0 Very High ≥68
1 High 46 – <68
2 Acceptable 30– <46
3 Low 10 – <30
4 Very Low <10

 

How Cairn Technology Can Help You Meet BS 40102 Regulations

We can measure the air quality throughout your healthcare setting and monitor your staff’s exposure levels to any potentially harmful substances. As well as the hazardous pollutants covered by BS 40102, we can also test for levels of sevoflurane, isoflurane, Entonox, and more. This will help you understand your risk levels so you can devise an air quality solution that works for you. Head here to learn more about our bespoke air quality monitoring services.

 

Xylene Medical Uses, Hazards, and Exposure Limits

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In this post, we’ll focus on the medical and dental applications of xylene. We’ll explore the exposure risks and advise on how you can best manage them to protect your staff from short- and long-term health effects.

What is Xylene?

Xylene is a colourless liquid, a volatile organic hydrocarbon with a distinctive sweet smell. It might also be referred to as dimethyl benzene, methyl toluene, and xylol. Xylene is used in many industries, and it carries certain exposure risks.

Xylene Medical and Dental Uses

Xylene has major applications in histology, or microanatomy. Technicians use xylene to process and stain tissue samples, making them transparent so they can better determine the presence of diseases. Histopathology technicians may also use xylene to clean slides of stains, to make them more visible under microscopes.

Xylene is also widely used as a cleaner in medical and dental settings, often as part of a disinfectant solution. Finally, certain chemicals containing xylene can have specialist medical uses. For example, P-xylene-2-sulfonic acid can be used as a reagent to determine cholesterol levels in serum.

Xylene Hazards and Exposure Risks

One major hazard of xylene is that it’s highly flammable at room temperature. This alone means staff should take great care when storing, handling, or transporting xylene. Also, xylene is not soluble in water, which can make containment and cleaning more difficult in the event of a spillage.

Xylene is highly irritant to the skin, and it can cause damage to the cornea if it comes into contact with the eyes. Yet the greatest risks come from inhaling xylene.

Effects of Short-Term Exposure to Xylene

In the short term, this can lead to dizziness, nausea, fainting, headaches, vomiting, visual impairments, and even heart arrhythmias.

Effects of Long-Term Exposure to Xylene

When xylene enters the bloodstream, it slows down the central nervous system. As a result, long-term exposure can result in major organ damage.

Xylene Workplace Exposure Limits

COSHH legislation means that staff must only be exposed to a certain amount of a hazardous substance in a specified period of time. This is known as the time weighted average (TWA).

Xylene has a TWA of 50 ppm, or 220 mg/m3 in 8 hours. The short-term exposure limit (STEL) is 100 ppm, or 441 mg/m3 in 15 minutes.

How to Manage the Risks of Xylene Exposure

  • Store xylene in tightly closed containers in a cool, dry, segregated, and well-ventilated area, away from any possible source of ignition. Eye wash facilities and emergency cleaning facilities must also be available.
  • Xylene must only be used in well-ventilated areas.
  • Any staff handling xylene should wear appropriate PPE. This includes safety goggles, protective gloves, and overalls to minimise all forms of skin contact. If there is insufficient ventilation in the area, respiratory protection will also be necessary.
  • In the event of a spillage, any contaminated clothing must be removed and washed before re-use. Cleaners should use a dedicated chemical spill kit to prevent the xylene from spreading and entering drains or water courses.
  • In the event of skin contact, wash the area thoroughly with soap and water, and seek immediate medical attention if irritation develops or persists.
  • In the event of eye contact, rinse eyes continuously for at least 15 minutes, removing any contact lenses before rinsing.

How We Can Help You Manage Xylene Exposure Risks

We offer a range of products and services that will help you protect your staff from the hazards of xylene exposure:

  • Workplace Exposure Monitoring – Using both continuous monitoring and personal sampling techniques, we’ll help you ensure you’re meeting your COSHH obligations wherever your staff are exposed to xylene in your healthcare setting.
  • Chemical Spill Kits – In the event of a xylene spillage, our specialist chemical spill kits will help your staff contain the substance as quickly and effectively as possible. We can also train your staff to ensure they understand the correct containment procedures.

For more information about how we can help you manage the xylene exposure risks in your hospital, call us on 0333 015 4345 or email info@cairntechnology.com.

How To Manage an Outbreak of C. difficile

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Clostridium Difficile Infections (CDIs) are among the most common hospital acquired infections.

In this post we’ll discuss what C. difficile is and how it spreads. We’ll then explore how robust cleaning protocols and procedures can help you manage a C. diff outbreak.

What is C. difficile?

Clostridium difficile is a type of bacteria which usually lives harmlessly in your bowels. However, certain antibiotic treatments can change the balance of bacteria in the gut, which can trigger a C. difficile infection.

Symptoms of C. difficile Infection

Common symptoms of a C. difficile infection include:

  • Diarrhoea
  • Loss of appetite
  • Stomach ache
  • Nausea
  • High temperatures

How is C. diff Transmitted?

As one of the main symptoms of C. diff is diarrhoea, C. diff infections can spread quickly. When outside the body, the C. diff bacteria can turn into spores which are capable of surviving for long periods on hands, surfaces, objects, clothing, and linen.

Without regular washing and cleaning, it’s all too easy for these spores to transmit from a surface to a person’s mouth, which could result in an infection. For example, a person might touch a surface containing C. diff spores with their hand. They might then, without thinking, wipe their mouth with their hand.

Read our full guide to how communicable diseases spread.

What Places are Most At Risk of a C. diff Outbreak?

Any healthcare setting where patients or residents share facilities is particularly at risk of a C. diff outbreak.

This might include:

  • Care homes
  • GP clinics
  • Hospital wards
  • Dental surgeries

Who is Most At Risk of a C. diff Infection?

As well as people taking certain antibiotic treatments, people aged 65 or over are particularly at risk of C. difficile infections.

How to Manage a C. diff Outbreak

A person with a C. diff infection may carry an infection risk until 48 hours after their symptoms have passed. So ideally, anyone with a C. diff infection should stay at home until at least 48 hours after their symptoms have cleared up. Though in a healthcare setting such as a care home or a hospital, this might not be possible.

As a result, only stringent cleaning procedures and protocols can help prevent and control C. diff outbreaks:

  • Practice good hand hygiene. Staff should adopt the appropriate hand washing technique, and commit to washing their hands at certain key moments – such as before and after touching patients or their surroundings. You should also provide patients and residents with appropriate hand sanitiser so that they too can practice effective hand hygiene.
  • Clean the care environment as often as possible. Your cleaning procedures should already ensure you’re carrying out thorough cleaning at least once a day. But your cleaning procedures should intensify in the event of an outbreak, paying particular attention to any surfaces that people might touch, such as toilets, light-switches, and door handles.
  • Wash any contaminated clothes and sheets as soon as possible, and separately from other washing.
  • Advise visitors to take extra precautions – or to avoid visiting completely – for the duration of the outbreak.

Read our full guide to managing outbreaks in care homes.

How We Can Help You Manage a C. diff Outbreak

We stock an advanced range of highly effective cleaning and containment products that will help you prevent and control C. diff and other infections in your care setting.

Our range includes:

  • Virusolve+ Wipes – A one-step solution, all-in-one cleaner, sanitiser, and disinfectant that can kill C diff bacteria on surfaces in as little as 5 minutes. It then creates a residual barrier that can help prevent infection for up to 7 days. You can use them on any surface, including carpets, upholstery, and mattresses. Also available as a trigger spray and a concentrate.
  • Virusan – Antimicrobial hand sanitiser and hand scrub capable of removing up to 99.999% of the most common germs in less than a minute, designed to eliminate the risk of cross-infection from hand transfer within 30 seconds of application. Also available as a gel.

We also stock hospital-grade air purifiers. In the event of a C. diff outbreak, they can quickly and effectively catch and kill airborne spores, completely cycling the air in a room in as little as 12.5 minutes.

For more information about how we can help you manage C. diff outbreaks in your care setting, call us on 0333 015 4345 or email info@cairntechnology.com.

Infection Control Legislation For Care Homes

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In this post, we’ll take a closer look at how this legislation relates to infection prevention and control in care homes.

Relevant Legislation for Care Homes

If you manage a care home, you have a legal obligation to implement stringent infection prevention and control policies and procedures.

The Health and Social Care Act 2008 gives the Care Quality Commission powers to enforce best practice regulations in all health and adult social care sectors.

You can read the full wording of The Health and Social Care Act 2008 here.

The Health and Social Care Act 2008 only applies to England. There are different legislations in Scotland, Wales, and Northern Ireland. We are focusing on the English legislation in this post because it provides an effective introduction to how the regulatory systems works in the UK.

Regardless of the specific legislation that might apply, your obligations are effectively the same:  If you don’t prioritise your residents’ health and wellbeing, regulatory bodies can and will take action against you.

What Are Regulated Activities?

The Health and Social Care Act 2008 defines a “regulated activity” as “an activity of a prescribed kind”.

“Prescribed activity” essentially refers to activity that “involves, or is connected with, the provision of health or social care in, or in relation to, England”.

Regulation of Regulated Activities

The Act gives the Secretary of State powers to “impose requirements … necessary to secure that services provided … cause no avoidable harm to the persons for whom the services are provided.”

This includes making provisions and imposing requirements as to the:

  • Fitness of premises.
  • Keeping of records and accounts.
  • Management and training of anyone who works for the purpose of carrying out the regulated activity.

And crucially, the Act outlines that regulations “may make provision for the prevention and control of health care associated infections and may include such provision as … appropriate for the purpose of safeguarding individuals … from the risk, or any increased risk, of being exposed to health care associated infections or being made susceptible, or more susceptible, to them.”

The Act also gives the Secretary of State powers to issue codes of practice relating to health care associated infections.

What Happens If You Don’t Meet Infection Control Regulations?

The Health and Social Care Act 2008 makes it clear that you have a legal obligation to meet any codes of practice relating to infection prevention and control. If you do not meet these regulations, the Care Quality Commission can take action against you.

This might include:

  • Issuing notices outlining improvements you must make, and by when you should make them.
  • Imposing conditions or restrictions on your practices for a given time.
  • Putting special measures in place to supervise your activities.
  • Holding you to account through issuing cautions, fines, or even through prosecution.

You can read some examples of instances where the Care Quality Commission has used its powers of prosecution.

How To Meet Your Infection Control Regulatory Requirements

We’ve put together a number of guides to help you ensure effective infection control in care homes:

We specialise in supporting healthcare settings, including care homes, in the delivery of effective infection prevention and control policies:

Want to talk about how we can help you meet your infection control regulatory requirements? Get in touch to talk to one of our friendly experts today.

Dental Decontamination & Infection Control Checklist

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Just like any other healthcare setting, dental surgeries need to adopt numerous infection prevention and control measures. Key to this is understanding the key sources of infection, and the means by which infections might spread.

Key Sources of Infection in Dental Practices

Communicable diseases usually spread via direct contact with a person carrying the infection. Dentists and dental nurses work in very close proximity to their patients, and with each other. Such close contact can make cross-contamination more likely – whether that’s from staff to patient, patient to staff, or from staff to staff.

Yet pathogens can also survive on surfaces for hours, days, or months. A patient or a member of staff could quite easily pick up an infection through simply touching a door handle that an infected individual also happened to touch. But much more serious would be a dentist or a dental nurse using a contaminated device on a patient. Given the nature of dental treatments, this could easily introduce pathogens into the patient’s bloodstream.

How to Prevent and Control Infection in Dental Practices

Dental practices should follow the same Standard Infection Control Precautions (SICPs) as other healthcare practitioners. These precautions include:

  • Personal Protective Equipment (PPE) policies – including using adequate PPE for the task at hand, and effective storage, handling, and disposal of any PPE used.
  • Good hand hygiene techniques – not just in terms of how to wash your hands, but also in terms of when you should do so.
  • Cough and sneeze etiquette – catch it, bin it, kill it.

Other key infection prevention and control precautions include safe management of the care environment, and of any equipment used on or around patients. In short, this means following robust cleaning and decontamination procedures.

Dental Decontamination & Infection Control Checklist

The NHS Infection Prevention and Control team recommends dental clinics perform weekly audits to ensure that they can maintain their environmental cleanliness standards.

Following a checklist could help ensure you don’t overlook any crucial areas of your dental practice.

Here are some things that your dental decontamination and infection control checklist could cover:

  • Reception and Waiting Areas
  • Corridors
  • Surgeries
  • Utility Rooms
  • Toilets
  • Storage (with separate checks for the cleaners’ storage room, and anywhere dental supplies are stored).

For each area, there should be at least two levels of checks:

  • Essential Check – The area is visibly clean, and free from any clutter or unnecessary items.
  • Thorough Check – A more detailed audit of any surfaces or items that might act as vectors for cross-contamination. Different areas of the clinic will require different checks. But in general, you should pay attention to anything that staff or patients might touch, and any surfaces where pathogens could thrive. This could include light switches, furniture, magazines, pictures, pamphlets, carpets, curtains, and so on.

Though high standards of cleanliness are essential throughout the dental practice, you’ll likely need to follow more stringent cleaning procedures in any areas where treatment take place.

You’ll find a good dental decontamination audit tool template on the NHS IPC team’s website.

Effective Decontamination of Dental Equipment

When it comes to dental equipment, dental staff must consider three separate levels of decontamination: cleaning, sterilization, and disinfection.

All dental equipment and devices will have different risk levels depending on how frequently they’re used, and where they’re used. This risk level will determine the level of decontamination required, and how often the decontamination procedure should take place.

Read our full guide to the three levels of decontamination for medical devices here.

Essential Support for Effective Infection Prevention and Control in Dental Practices

We stock a full range of highly effective hospital cleaning and containment products, including the powerful Virusolve+ range of wipes and concentrates. Browse our complete range of infection control products.

With our air purifiers, we can also help you trap and kill up to 99% of airborne viruses and bacteria in your dental surgery, along with up to 99.9% of potentially hazardous pollutants, such as VOCs, inhalable dust, and particulate matter. Browse our range of air purification solutions.

 

Environmental Decontamination: Stages & When to Implement

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In a healthcare setting, “environmental decontamination” refers to the process of thoroughly cleaning surfaces as part of effective infection prevention and control.

In this post we’ll discuss the various stages of environmental decontamination in hospitals and healthcare settings and explain when these should be implemented.

The Role of Environmental Decontamination in Infection Prevention and Control

Staff and patients carrying communicable diseases can shed pathogens in a number of ways. These pathogens can survive on surfaces for hours, days, and even months.

In this way, contaminated surfaces can contribute to the person-to-person transmission of pathogens in healthcare settings. This presents a serious risk for certain high-risk patients, including the elderly, the immunocompromised, and the immunosuppressed.

Patients from high-risk groups may be more likely to contract infections from contaminated surfaces. And if they do pick up an infection, they’ll be more likely to experience severe symptoms.

While manual cleaning can contribute to infection prevention and control, if the cleaning agent itself becomes contaminated with pathogens, then the cleaning process could actually contribute to the spread of infection. Environmental decontamination goes beyond surface level cleaning. It’s a strategy for removing and destroying infectious pathogens and contaminants.

The Three Stages of Environmental Decontamination

  1. Cleaning
  2. Enhanced cleaning
  3. Disinfection

Stage 1: Cleaning

The cleaning stage of the environmental decontamination process involves physically removing dirt, dust, and other contaminants from surfaces.

In most healthcare settings, cleaning should take place at least once a day.

Using a combination of mops, brushes, cloths and detergents, cleaning will remove the sort of organic matter from surfaces on which pathogens can take hold. However, it is unlikely to eliminate potentially harmful microorganisms entirely.

As such, cleaning might suffice for items and surfaces that will not come in direct contact with the patient.

Stage 2: Enhanced Cleaning

Some infection prevention and control procedures will call for enhanced cleaning processes. This might simply extend to an increased frequency of fundamental cleaning processes. Or it may call for the use of more specialised disinfectants or equipment.

In some areas of the hospital, such as an operating theatre, enhanced cleaning procedures may take place as a matter of course as part of a wider infection control protocol. Otherwise, enhanced cleaning might be recommended as a response to an outbreak of a communicable disease (such as norovirus); or as part of a containment response to a spillage (of bodily fluids, or chemicals etc.)

Stage 3: Disinfection

Enhanced cleaning may remove microbes and pathogens, but it will not necessarily kill them. Manual disinfection can actively reduce the levels of infectious agents in the area.

As with enhanced cleaning, disinfection may extend to simply making use of specific disinfectant agents as advised. And as with enhanced cleaning, disinfection might be standard practice in some healthcare settings, or it might be recommended as part of the response to a specific event.

For example, any surface contaminated with bodily fluids, such as blood or diarrhea, will require disinfection. Cleaning and enhanced cleaning processes will first serve to make the area visibly clean. Meanwhile, manual disinfection will serve to remove as many lingering microbes as possible.

Different Decontamination Procedures for Medical Equipment

As the name suggests, environmental decontamination is all about removing pathogens from the healthcare environment. This might involve floors, surfaces, windows, items of furniture, and so on.

When it comes to medical equipment – particularly items that might come into contact with a patient’s mucous membrane – healthcare workers must consider three separate levels of decontamination: cleaning, sterilization, and disinfection.

All medical equipment and devices will have different risk levels depending on how frequently they’re used, and where they’re used. This risk level will determine the level of decontamination required, and how often the decontamination procedure should take place.

Read our full guide to the three levels of decontamination for medical devices.

Essential Support for Effective Environmental Decontamination

We stock a full range of highly effective hospital cleaning and disinfectant products, including the powerful Virusolve+ range of wipes and concentrates. Browse our complete range of infection control products.

With our hospital-grade air purifiers we can also help you reduce the levels of airborne pathogens in your hospital, along with other potentially hazardous pollutants, such as VOCs, inhalable dust, and particulate matter. Browse our range of air purification solutions for healthcare settings.