Dr. Tracey Cooper:

There are lots of issues and some of the committee members have articulated them. There is no deliberate intent not to do it. I would say that there has not been sufficient leadership to ensure that hand hygiene is done.

Recently one member of the team had a discussion with a junior doctor fresh out of medical school who said that they were taught hand hygiene once in medical school in third year. There is something about how we institutionalise such hygiene. We must ensure that all health and social care professionals are educated and told what is expected of them in the workplace. Hand hygiene needs to be embedded as a normal part of work.

Last week someone made the comment that people are too busy to practice hand hygiene. That is not an excuse but hygiene could be made easier. Some sinks are five bays away, there is not a sink in every bay and sinks or cleansing gel may be inaccessible. It could be more in the space for people to use hygiene in their basic approach. The evidence is very clear and I quoted the World Health Organization. Hand hygiene has become one of its priorities and its guidance has been broadcast across the world. It clearly stated the five moments for hand hygiene that are opportunities that will reduce infections. I have made the point that hand hygiene is the single most important measure to prevent the transmission of infection.

We have noted that the second standard that we examined was environmental hygiene. We know that the risks of transmission of infection are significantly reduced by a clean and decontaminated environment and equipment. We do not necessarily mean that one should buy lots of new stuff. We are just saying to keep it clean and human behaviour is at the heart of that. A number of factors are involved. We need to ramp up accountability. Everybody is accountable for their own hand hygiene but some people are more accountable for making sure that all of their workforce do so. If I were a hospital chief executive I would want to know that such practice was strongly embedded in business. It is a normal part of business in 2013.