Value for Money?

A new set of draft standards for infection prevention and control, has been published by the Health Information and Quality Authority (HIQA). HIQA was established in May 2007 as an independent Authority, with broad ranging functions and powers, reporting to the Minister for Health. It was set up to drive safety, quality, accountability and the best use of resources in our health and social care services. Our present health service is neither efficient nor cost effective, it swallows up vast sums of money with poor return. HIQA aims to correct this imbalance and deliver value for your money.

The new standards once finalised, will provide a national framework to improve the performance of healthcare settings in order to reduce healthcare associated infections (HCAI’s). These standards are a key component in ensuring quality and safety. As Eithne Donnellan reports in the Irish Times today, “the standards cover accountability, hand hygiene, reducing infection from medical instruments, surveillance of infections, having appropriate multidisciplinary infection-control teams in place which reflect the size and specialities of a facility, informing patients immediately of their infection status, and management of outbreaks“. HIQA now wishes to consult with interested parties and the general public before drawing up a final set of standards to be published later this year. Everyone has a right to have their view considered and submissions can be made online here to the Authority until the 18th July, 2008. HIQA envisages having the standards finalised and ready for ministerial approval by September.

I’m really pleased to see that the Department of Health is taking infection prevention and control extremely seriously but I’m not convinced that we’re getting value for money. You see, I’m aware that the HSE published an updated set of comprehensive guidelines back in 2005, called “A Strategy for the Control of Antimicrobial Resistance in Ireland ( SARI)” but these guidelines, which have a marked similarity to the new standards drawn up by HIQA, were never implemented. It was publicly acknowledged by the HSE at the time that the guidelines failed because of inadequate resources, sub-optimal infrastructure and a lack of access to relevant expertise locally. Has anything changed in the interim, I ask? Forgive me if I’m wrong, but it seems to me that there’s very little new about the report published yesterday other than the change of name. I’d love to know how much it’s cost to date. Meanwhile, the health service continues to struggle on with it’s inadequate resources and sub-optimal conditions. HIQA faces a hard task ahead.

7 Responses to Value for Money?

  1. Knipex says:

    I sat down and read the draft standards last night.

    I have to say I am impressed.

    On page two they emphasised that money spent on infection control will result in a net saving to the HSE. Getting this point across to hospital management is vital and this is the first time it has been accepted and published in guidelines. It could and should go along way towards increasing the emphasis on infection control when budgets are tight.

    It also states that infection control and prevention standards in hospitals will be audited and enforced. Going by previous HIQA reports the findings will be published so again bringing failures at particular hospitals into the public eye.

    Places clear responsibility for infection control on management. The buck now stops with one person who who be a CEO or senior manager.

    There is big emphasis now placed on training and ensuring that all staff have received infection control training and that infection control staff have received specialised training.

    Its acknowledged that different areas within hospital require different standards with higher risk areas having more stringent and specific requirements.

    The importance of environmental decontamination as opposed to “visually clean” cleaning is emphasised. This represents a major change in current protocols and is in line with emerging evidence and international best practice.

    It also sets standards for the microbiology facilities that must be in place.

    There are now specific surveillance procedures in place.

    And it emphasises the role of antibiotic stewardship setting requirements for communication between individual departments.

    All in all its a credit to the team that put it together and hopefully the catalyst that will reduce HCAI’s in Ireland.

  2. Baino says:

    Steph it seems so often that a bevvy of public servants and highly qualified interested people put in hard yakka to develop policy and guidelines only to be frustrated by their lack of implementaton. Surely now it’s time to move on to actually legislating and enforcing punitive measures to ensure that infection is properly contained.

  3. Knipex says:


    I agree 100% and that is why I am thrilled it is HIQA who have generated these guidelines and will be auditing them.

    At the very least this will result in non compliant hospitals being named and shamed. Ultimately I would like to see HIQA having the authority to withdraw approval for these hospitals and as a result cutting off their supply of money from the HSE until they are compliant. In the short term this solution would result in problems for patients but in the long term it would be good for patients.

  4. Caoimhin says:

    The HIQA seems to be on the right track Steph, let’s see if they can get results! 🙂

  5. Steph says:

    Cheers! folks

    It’s good to have something positive to report about the health service FOR A CHANGE!

  6. Roy says:

    A simple idea; if they could return to set visiting times it would help a lot!

  7. Steph says:

    Cheers! Roy

    I totally agree. Visiting hours on the ward should be limited and restricted to close family members only. With the proliferation of mobile phones, the majority of patients can easily keep in contact with extended family and friends via texting – as long as phones are kept on ‘silent’ and patients leave the ward to make a call.

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