Healthcare Associated Infections: Local roles and responsibilities of the Health Protection Agency Chris Booth, Unit Director, The Greater Manchester Health Protection Unit November 2007

HPA inherited widely variable practices HPA Framework document will require clear specification of HPA core role HCC reviews suggest certain expectations of HPA Role of the local HPU: Drivers Healthcare Commission, 11 Oct 2007 'The NHS and the Health Protection Agency should agree clear and consistent arrangements for the monitoring of rates of Clostridium. difficile infection, using all relevant local and national information. Local health protection units have an important role to play in this.'

HPA recognises that: Formal responsibility for control of HCAI lies with NHS Trusts Much of the expertise also lies with NHS Trusts. Responsibility for performance management of NHS bodies lies with the PCTs and SHAs. Nevertheless: HPA has an important role in supporting and advising NHS Trusts. This support must be proactive Local Roles and Responsibilities: Principles

Every HPU provides a point of access to the HPA as a whole so that advice and support may not be delivered by an HPU working in isolation. There are HPA wide responsibilities, delivered jointly by Local and Regional Services (LaRS) and the Regional Microbiology Network with support from the Centre for Infection (CfI). Local responsibilities can be delivered with cross- divisional support

Advice: Providing advice and support on an on-going basis through active membership of infection control committees and networks. Surveillance: Maintaining awareness of local Trust HCAI surveillance data, monitoring trends and discussing emerging problems with the trust infection control team(s). Liaison: Facilitating the cascading of information across the NHS and acting as a link between acute trusts and PCTs where appropriate Key Local HPU Roles and Responsibilities

When problems occur: Supporting investigations and control of incidents/outbreaks through active membership of trust outbreak control teams. Raising concerns formally with performance managers (SHA, PCT, Monitor) when NHS bodies have inadequate infection control systems in place, or fail to address incidents/outbreaks appropriately, or fail to respond to HPA advice. Co-ordinating investigations of outbreaks/incidents (including look-back exercises) involving more than one NHS organization. HPA may provide leadership in such investigations by agreement with NHS. Key Local HPU Roles and Responsibilities