1. Driving the HCAI agenda, Widening the net Gaynor Evans

2. Health economy approach Changing the focus from acute trust surveillance to a healthcare provider approach The dual role of PCTs (commissioner/provider) Defining community HCAI and identifying the impact on non NHS healthcare facilities Establishing multi organisational networks to address the burden of HCAI Embedding the responsibility for reducing HCAI within the culture of all healthcare providers Coordinating action across defined population areas by implementing joint responsibility action plans

3. Interface between healthcare providers| Acute trusts PCTs Mental Health trusts Ambulance trusts Private hospitals Learning disability units Laboratories Local Authorities (Including Social services) Care homes Hospices Voluntary services CSCI StHA HCC DH Improvement teams

4. Setting rules of engagement Clear organisational roles and responsibilities Formal agreement of accountability Clear reporting mechanism for compliance with governance in health economy Stakeholders HPA SHA

5. Reducing HCAI- Targeted strategies Leadership responsibility/ accountability Communication developing public health information Surveillance addressing the gaps Training and developing skilled workforce. Research Improving joint actions with RMN (inc antimicrobial prescribing) Commissioning Governance

6. Challenges to success Accountability Resistance to change Organisational change Personal ownership at all levels of the organisation Protected time training Governance Poor leadership

7. Challenges to success work with health economy to develop robust and timely communication mechanisms. In collaboration with StHA to implement lessons learned from the outcomes of RCAs across the WM work with PCTs to improve commissioning post discharge info for GPs and patients work with other organisations to create robust interagency networks Communication

9. Challenges to success What target? Finance, A&E waiting, surgical waiting versus HCAI Are the targets sustainable long term? Performance targets- are they unreasonable or a way to focus action? Competing Targets

10. Challenges to success Resources Human Financial Skills deficit -workforce development Training and education Poor / lack of facilities

11. Challenges to success Contemporaneous data Communication with labs Interpretation and analysis Meeting the needs of stakeholders Is it reflecting a health economy perspective? Is appropriate skill mix reflected in modern infection prevention and control Gaps in Surveillance

12. “ If there is a choice between changing human behaviour and new technology, go with the new technology every time!” Rob Weinstein MD.