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Care Quality Commission

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Care Quality Commission

    Agenda Item: 3.6

    Ref: W08-09/218

    NHS Wirral

    Care Quality Commission

    NHS Wirral Registration Health Care Associated Infections

    1. The Care Quality Commission (CQC) was established to regulate the quality of health and adult

    social care and look after the interests of people detained under the Mental Health Act. It

    became a legal entity in October 2008 and takes up its responsibilities for health and social care

    in April 2009.

    2. CQC will replace the Healthcare Commission, CSCI and the Mental Health Act Commission.

    3. The Care Quality Commission, established in October 2008 by the Health and Social Care Act

    2008 (2008 Act), will have enforcement powers that include the CSA 2000 powers and three new

    powers under the 2008 Act.

    4. The 2008 Act will come fully into force in April 2010. However, regulations are being made that

    will apply to NHS organisations covered by the Code of practice for the prevention and control of

    healthcare associated infections. These regulations will come into force from April 2009.

    5. This will mean that, from April 2009, NHS providers will be required to register with CQC and

    comply with the new requirements and regulations under the 2008 Act that require them to

    protect patients, staff and others from identifiable risks of acquiring a healthcare-associated

    infection (HCAI).

Registration

    6. Registration is a new concept for the NHS „though already happens in independent healthcare

    and social care. It will in effect be a “licence to operate”.

    7. The bulk of requirements for registration will not come in to effect until 2010/11. The PCT will

    however need to register in respect of HCAIs ahead of 2009/10.

Who should apply to register in respect of HCAIs

    8. The same NHS providers that are currently subject to the hygiene code should apply to register

    in 2009/10. These are NHS Acute Trusts, NHS Ambulance Trusts, NHS Mental Health Trusts

    and Primary Care Trusts (PCTs). The requirements apply to both foundation and other trusts.

    This means that PCT services, such as community nursing, will be included during 2009/10

    (because they are covered by the current hygiene code), but most general practice, for example,

    will not.

    Trusts can apply to register with the Care Quality Commission in relation to HCAI between 12 January and 6 February 2009.

    9. From 1 April 2009, any trust providing services that has not registered will be committing an

    offence.

    Care Quality Commission NHS Wirral Registration Health Care Associated Infections:

    Board Meeting 10 February 2009 1/3

    Agenda Item: 3.6

    Ref: W08-09/218

    NHS Wirral

The changes

    Current system New system

    At the moment, trusts are legally The new legal requirement is that each trust is,

    obliged to “observe the provisions” of and will continue to be, in compliance with the the hygiene code. regulations setting out the requirements on

    HCAI.

     • Trusts will need to apply to the Care Quality

    Commission for registration any unregistered

    trust that continues to provide services without

    permission would be acting illegally.

    The detailed provisions of the hygiene The Care Quality Commission will decide code are fairly prescriptive. whether trusts are meeting the legal

    requirements. They will make this decision by

    referring to the high level compliance criteria of

    the revised code, using information provided by

    the trust on its application, and other relevant

    evidence.

    The annual health check links three Applications for registration look at the present core standards to the provisions of the and also the future. Trusts will, in this hygiene code (C4a, C4c, C21) and transitional year, still be required to declare trusts must make a statement on the retrospectively against the three relevant core

    measures they have in place to standards for the 2008/09 annual health check, comply with the code. but will not be required to make an additional

    statement about HCAI.

    Each acute trust receives an annual Following registration the Care Quality inspection visit from the Healthcare Commission will continue to monitor all trusts Commission‟s HCAI team. The and carry out inspections.

    Healthcare Commission is also

    visiting some non-acute trusts during

    2008/09.

    The Healthcare Commission has The Care Quality Commission will have a wider powers to issue improvement notices range of enforcement powers.

    and recommend special measures.

     A wider registration system, covering all

    aspects of care (not just HCAI), will apply from

    April 2010. It will align registration systems for

    the NHS, independent healthcare and adult

    social care.

    10. What is different is that trusts must, by law, comply with one overarching regulation about HCAI,

    which requires them to operate in a way that, as far as practicable, protects patients, workers

    and others from identifiable risks of acquiring an HCAI. Trusts must publicly state, in their

    application form, whether they comply (and will continue to do so). If CQC determine that a trust does not meet this registration requirement they may not be able to register it. An

    unregistered trust that continues to provide healthcare would be committing a criminal offence

    and may be prosecuted.

    Care Quality Commission NHS Wirral Registration Health Care Associated Infections:

    Board Meeting 10 February 2009 2/3

    Agenda Item: 3.6

    Ref: W08-09/218

    NHS Wirral

Registration Requirements

    11. To be able to register with CQC, the PCT must demonstrate compliance with nine criteria

    relating to the prevention and control of HCAI‟s. The format for registration, including the criteria,

    is attached at Appendix A.

    12. For the last two years, NHS Wirral has declared compliance with Standards for Better Health

    core standards relating to HCAIs and has, as required, included a statement of compliance with

    the Hygiene Code.

    13. The PCT Board agreed an action plan for 2008/09 as part of the Director of Infection Prevention

    and Control‟s (DIPC) Annual Report (Board Meeting September 2008). The Infection Prevention

    and Control (IPC) team further developed a workplan to deliver the actions identified.

    14. A review has been undertaken of the HCAI workplan to assess progress, developments and

    available evidence since our last annual health check declaration.

    15. This review shows further progress and developments in place since our last declaration and

    statement of compliance and supports NHS Wirral being in a position to declare it meets all nine

    criteria and applying for registration with CQC.

16. The PCT Board approved:

    ; declaring compliance with HCAI requirements

    ; declaring that it meets all nine criteria set out in the Code of Practice.

    ; application for registration with CQC

    via e.mail correspondence to allow registration before the deadline on 6 February 2009.

     Recommendation

    17. The Board is asked to formally approve NHS Wirral declaring compliance with HCAI

    requirements and declaring that it meets all nine criteria set out in the Code of Practice.

Alex Dalgarno

    Head of Corporate Affairs

    30 January 2009

Care Quality Commission NHS Wirral Registration Health Care Associated Infections:

    Board Meeting 10 February 2009 3/3

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