The Hygiene Code

In October 2006, the Government handed the NHS and the Healthcare Commission a powerful new tool in fighting infection – the Health Act 2006 hygiene code. The code explained how organisations should work to ensure that patients are cared for in a clean and safe environment. It outlined trusts’ duties to establish appropriate systems, assess and manage risks, implement clinical care protocols, ensure healthcare workers’ access to occupational health services and provide induction and training.

Inspections

All NHS trusts in England are legally required by the code to observe these provisions. In June 2007, we began a programme of unannounced inspections at 120 NHS trusts to check their compliance with the hygiene code. It is our biggest ever programme of inspections.

In this programme, about 10 trusts are inspected every month. Our assessors will look at a range of infection control issues such as cleanliness, prescription of antibiotics, isolation policies, the management of risks and board-level involvement. We publish their inspection reports in this section of the site.

If we identify serious breaches of the code, we have the power to issue a statutory notice requiring trusts to make improvements. If a trust does not respond adequately to an improvement notice, we can ask the Secretary of State (or Monitor, for foundation trusts) to impose special measures and oversee a programme of improvements in the trust.

Inspection reports and improvement notices

Reporting templates for hygiene code inspections

We have developed lines of enquiry for each duty of the hygiene code, to guide our assessors. When reporting on a trust's compliance, they use a separate template for each duty, which includes the relevant lines of enquiry. To view the templates, click on the links below.

Duty 2: Duty to have in place appropriate management systems for infection prevention and control (pdf 59kb) (opens new window)

Duty 3: Duty to assess risks of acquiring HCAI and to take action to reduce or control such risks (pdf 50kb) (opens new window)

Duty 4: Duty to provide and maintain a clean and appropriate environment for healthcare (pdf 59kb) (opens new window)

Duty 5: Duty to provide information on HCAI to patients and the public (pdf 45kb) (opens new window)

Duty 6: Duty to provide information when a patient moves from the care of one healthcare body to another (pdf 39kb) (opens new window)

Duty 7: Duty to ensure cooperation (pdf 39kb) (opens new window)

Duty 8: Duty to provide adequate isolation facilities (pdf 40kb) (opens new window)

Duty 9: Duty to ensure adequate laboratory support (pdf 40kb) (opens new window)

Duty 10: Duty to adhere to policies and protocols applicable to infection prevention and control (pdf 75kb) (opens new window)

Duty 11: Duty to ensure, so far as reasonably practicable, that healthcare workers are free of, and are protected from, exposure to communicable infections during the course of their work, and that all staff are suitably educated in the prevention and control of HCAI (pdf 54kb) (opens new window)

Work with trusts
We have been working with a number of trusts that we identified through the 2005/2006 annual health check as having some difficulties with controlling infection. These trusts have put systems in place to make sure that they comply with the hygiene code. We will develop a similar programme for trusts that report difficulties under the 2007/2008 annual health check.

The Health Act 2006: Code of practice for the prevention and control of healthcare associated infections (opens new window)

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