Agenda Item:5.4
Ref: W07-08/072
Wirral Primary Care Trust
Decontamination Strategy
Final Review
Introduction
1.
The national decontamination strategy “National Standards, Local Delivery” was
launched by the Department of Health in 2003. All Trusts were required to submit Trust
Decontamination Strategies to the SHAs in September 2005 outlining their approach to
comply with the national strategy by 31 March 2007. Bebington and West Wirral and
Birkenhead and Wallasey PCTs were successful in their bid for £50,000 each from the
SHA to forward their respective strategies.
2.
Both PCTs opted for a combination approach of single use instrumentation and
reprocessing by the proposed Joint Venture Central Sterile Supplies Department
(CSSD) for Cheshire and Merseyside.
3.
Following an agreed action plan both strategies have been reviewed in response to
developments with the proposed CSSD and guidance from the DoH and SHA.
4.
This is the final review of PCT Decontamination.
5.
It should be noted that compliance with the National Decontamination Strategy has
been included in the Code of Practice for the Prevention and Control of Health Care
Associated Infections and Healthcare Standard C4c.
Strategic Intention
6.
The PCT is committed to protecting patients and staff from potential risk due to the use
of surgical instrumentation. It is the PCT’s intention to put in place systems and
processes to ensure compliance with current legislation and the national
decontamination strategy.
7.
The aim of this strategy is to modernise the provision of decontamination services for
the reprocessing of surgical instruments by ensuring all methods meet accepted
national and professional standards in PCT services and those with independent
contractors, using solutions which are acceptable to the user, minimise risk of cross
infection and are equitable across the health economy of the Wirral.
Position up to April 2007
8.
Local sterilization (Benchtop sterilizers within the clinic setting):
 PCT Salaried Dental Services
 Independent Dental Services
 Podiatry Service
 Some General Practices
9.
Single use instrumentation:
 Women’s Services
 Unplanned Care Services
 Community Nursing Services
 Some General Practitioners
 All Dental Services for certain instruments (for Endodontic procedures)
Decontamination Strategy Final Review: Board Meeting 10 July 2007
1/3
Agenda Item:5.4
Ref: W07-08/072
10.
Central Sterilization (CSSD):
 1 PCT Salaried Dental Clinic, Arrowe Park Hospital
 1 Podiatry Clinic, Clatterbridge Hospital
Agreed position 1 April 2007
11.
Central Sterilisation (CSSD):
 Podiatry Services (excluding nail surgery) including the Podiatric Clinic at
Clatterbridge Hospital and Arrowe Park Hospital.
 PCT Salaried Dental Clinic at Arrowe Park Hospital.
The PCT has given an expression of interest to use the Joint Venture CSSD for some
equipment when this is available (expected May 2008). The Joint Venture CSSD will be
used by acute services across Merseyside, although not available for April 2007
agreement has been received from the Joint Venture Team that Trusts signed up to
participate in the venture can continue with current sterilisation procedures for those
services continuing with reprocessing until the new CSSD is on line. Instruments used
for Podiatric treatment excluding the more invasive surgical interventions, i.e. removal
of toe nails, will continue to be reprocessed locally using equipment and processes
compliant with HTM 2010 until a compliant CSSD is available. During this time the
Podiatry service is actively investigating other suitable compliant CSSDs which may
ensure a fully compliant service prior to the Joint Venture scheme.
12.
Single use instruments:
 Unplanned Care
 Community Services
 Women’s Services
 High risk Podiatric surgery
 General Practice
 Primary Care Dental Service – endodontic files, reamers and matrix bands
The range, quality and accessibility of single use instrumentation have increased
through all specialities and are felt to provide a cost effective alternative to current
sterilisation methods in community settings in line with the National Strategy, with the
exception of Podiatry services. It has been highlighted that the current style of the
single use nail clippers could expose staff to a greater risk of repetitive strain injury. In
light of this, use of all single use podiatry packs where nail clippers are included would
not be an option at this point in time. Single use packs for higher risk nail surgery i.e.
removal of toenails will be used.
13.
Local Sterilization:
 Primary Care Dental Services
Following NHS Dental reforms of 2006 and the development of the Primary Care
Dental Service the Department of Health have confirmed that all Dental services are
required to meet the British Dental Association professional standard for Infection
Control A12 (currently under review) to ensure an equitable standard between PCT
Employed Dental Services and Independent Dental Practitioners.
Capital Support Bid from SHA 2005
14.
Both PCTs received £50,000 from the SHA towards capital expenditure required to
meet the National Decontamination Strategy. The intention was to use the funding to
purchase additional reusable instrumentation required by Podiatry and Dental Services
to use a CSSD service. In light of the DoH correspondence and consequential Strategy
review these funds received for additional Dental instrumentation will require reallocating to meet the revised direction of the Strategy for PCT Salaried Dental
Decontamination Strategy Final Review: Board Meeting 10 July 2007
2/3
Agenda Item:5.4
Ref: W07-08/072
Services. This finance can only be used for capital expenditure and must be used to
ensure PCT Dentistry has a service in line with current recommendations.
15.
Considerations will be:
 Upgrading the equipment for the washing and disinfection of used instruments in
PCT Dental Clinics.
 Improved traceability systems in all clinics.
Assurance
16. The Decontamination Lead for the PCT has requested assurance from the Locality
Leads that General Practitioners will meet the requirements of the strategy. This is
currently being provided in the form of a signed declaration from individual General
Practitioners. Verbal reassurance has been received that General Dental Practitioners
already meet their current professional standard A12. The PCT is working with
Independent Dental Practitioners to gain evidenced assurance that the services meet
the revised standard A12 when published. PCT Dental Clinics currently meet A12; audit
will be conducted to evidence this requirement and that of the revised standard.
Recommendations
17. The Board is asked to note the final PCT position for the deadline of 1 April 2007 and
that changes to the PCT Strategy are in line with the National Decontamination Strategy
and British Dental Association Professional Standard for Infection Control A12.
Infection Control Team
Decontamination Strategy – Final Review
June 2007
Decontamination Strategy Final Review: Board Meeting 10 July 2007
3/3