As many of us already know, The Cleanyourhands campaign run by the NPSA was wound up in 2010 due to cuts in funding. Since the campaign was wound up many infection control nurses, cl...

Independent research has demonstrated success of the CleanYourHands campaign (1). Following closure of this campaign, the Hand Hygiene Alliance was formed with a shared concern around the sustainability of hand hygiene improvement, including continuing reduction in MRSA and other healthcare associated infections.

The Alliance comprises former members of the NPSA Expert Reference Group, patient lobby groups, specialist healthcare professionals and research workers from both hospital and community and behavioural scientists. Suppliers and developers of hand hygiene products are also amongst its numbers. Some of these individuals were members of the pioneering multidisciplinary group, the Hand Hygiene Liaison Group, which first made hand hygiene a national clinical governance issue in 1999, recommending widespread use of Alcohol Handrub at the bedside.

The Alliance is organizing a Hand Hygiene Summit to be held as part of the GovToday meeting in London on 24th October, 2012. What we aim to do at the summit is to Identify the most constructive way forward to sustain what has been achieved, highlighting emerging issues impacting on hand hygiene.


Part of the summit will include a ‘Dimbleby’ style debate between key figures in the landscape chaired by Consultant Surgeon, David Leaper.

The debate will examine vital questions, important for going forward. With this in mind, what questions would you like to ask to our expert panel?



1. An evaluation of the national Cleanyourhands campaign, an initiative to reduce Staphylococcus aureus bacteraemia and Clostridium difficile infection in hospitals in England & Wales through improved hand-hygiene: a four year prospective ecological interrupted time-series study

Sheldon Paul Stone, Christopher Fuller, Joan Savage, Barry Cookson,Andrew Hayward, Ben Cooper, Georgia Duckworth, Susan Michie, Miranda Murray, Annette Jeanes, J Roberts, Louise Teare, Andre Charlett British Medical Journal: 26 May2012; 344, 17 -19.

I am looking forward to hearing Julie Storr et al (The Alliance)at the Conference in October as I am sure the work already done by NPSA and pioneers like Julie will not be forgotten.

1) Whilst continuing to target and maintain staff hand hygiene compliance are there any national initiatives to help patients understand their role in promoting good hand hygiene standards – including being willing (where able) to provide adequate hand hygiene facilities for staff caring for them in their homes e.g liquid soap and kitchen roll for DN’s to use?
2) With so much pressure, and possible financial penalties, on organisations to demonstrate excellent hand hygiene results is there a risk that some organizations may ‘massage’ their figures and thus those who provide accurate but not perfect scores will be penalized for their honesty?

Although we say that the rates of MRSA is on the reduce, why is it that many patients are diagnosed with MRSA following any surgical interventions in hospitals? Is it poor hand hygiene, poor decontamination in surgery or is it poor hand hygiene on the post operative wards? I must say that I have received patients that went in for day surgery and returned the same day with MRSA in the site of surgery.

I am greatly looking forward to the debate on this day which I believe will raise some very important issues and should also inspire and enthuse the delegates in attendance.

What strategy is in place to ensure doctors and all healthcare trainees are trained and more so, apply the HCAI standard when in the coalface of working in an environment are faced with resistance, by their leaders. How can they act as role models to bring positive change without having to continually monitor practice, so that it is an embedded part of patient care pathway?

Has hand hygiene been shown to be the single most important factor in reducing the spread of HCAI?

Have business cases been put forward successfully to NHS Trusts to fund additional bed space to cohort MRSA/C diff patient carriers?

We have fitted alcohol hand rube at suitable places in corridors so that any-one coming out of a residents room or a communal room will find one near-by. We think that this is the best way of making it likely that staff and visiting health-care workers will in fact clean their hands after each contact. However one GP commented that the alcohol works only for certain infections, and he washed his hands with soap and water. Obviously the alcohol is much more convenient and likely to be used. Infections we encounter here include occasional diarrhoea, but have included MRSA and C-diff acquired previously. What should be the policy on soap-and –water vs. alcohol rub?

I understand the gold standard requirements for hand hygiene facilities, however in the current financial landscape accessing funds is extremely difficult to make improvements.
My particular area of concern is for the cinderella service of Community Equipment Service. My current service has not had the investment it deserved due to a variety of reasons, including this being a leasehold & inappropriately designed building.
Will alcohol hand disinfectants be adequate for this service in the absence of a sink and running water for next 12 months?

As chair of the charity MRSA Action UK Hand Hygiene has been at the forefront of our charity’s campaign for safer standards and I have seen the last few posts and been dismayed. I hope someone will forgive my presumption but I believe that the last few posts have not been made by people from the medical profession, but if so then I wanted to clarify some salient points that give me cause for concern after 7 years of hand hygiene being in both the public and medical professions eye’s. In relation to the first point by Graham Terry “Has hand hygiene been shown to be the single most important factor in reducing the spread of HCAI?” I am amazed the question has been asked after all this time. Does no one read history and Florence Nightingale or Ignaz Semmelweis and their proven theories? If we are asking this question now after 7 years then god help us. You would expect a chef to wash his hand before preparing food you are going to eat, why not the medical staff before they treat or touch a patient.

On his second point “Have business cases been put forward successfully to NHS Trusts to fund additional bed space to cohort MRSA/C diff patient carriers?” maybe you need to employ a good risk management assessor just like the Nuclear and Airline industries have done for years. Having instances where patients contract infections that are avoidable is not good business practice whether it’s in the private sector or the NHS.

In Answer to Graham Rainbird’s point “What should be the policy on soap-and –water vs. alcohol rub?” there is no policy. If you read the Healthcare Commission Report on the debacle at Maidstone and Tunbridge Wells hospital in 2007 you would not be asking this question. There is no substitute for good hand washing and using the gel appropriately, dozens died in that hospital because of the cramped conditions and the staff thinking that the alcohol gel was a substitute for good hand washing and killed all bacteria which it doesn’t.

In answer to Eng Choo Hitchcock no it wouldn’t.

Hi Derek, thanks for the comments. I think our users were simply putting forward questions for the Debate held on the day, as Louise and the Hand Hygiene Alliance have requested.

How do you plan to keep mometum with the campaign to ensure we maintain our high compliance rate ?

How accurate are we in measuring compliance?
Are there any initiative set up for improving hand hygiene in developing countries such as Africa?

We have had the campaigns,poster displays,glow box sessions;yet some healthcare workers are too “posh to wash”.What is the way forward as we strive the break the chain of infection?