Biology, politics and performance management: tackling healthcare-associated infections in the NHS in England

Abstract

Infection is different from other aspects of medical care and clinical practice because it spreads. That is the defining characteristic of infection and it means that for every infected patient who needs treatment for their illness, there are two further questions – where has the infection come from, and where (to whom) may it have spread? The study of infection is a fascinating biological interaction between microbial populations and human populations with a variety of influencing factors linked to human behaviour. This includes the behaviour of patients, their relatives and, importantly, their healthcare attendants, particularly doctors and nurses. These factors have critical importance in relation to healthcare-associated infections. These infections are complications of a patient's underlying, primary illness or of the treatment they have received for that illness. They used to be called ‘hospital infections’ but they know no boundaries across health and social care because the bacteria move with people (both patients and staff) and these infections affect all health and social care settings. Therefore, responsibility for infection prevention and control lies across the whole health and social care community.