Actions to ensure system structures and processes work to reduce Gram-negative bloodstream infections (GNBSI). Examples of good practices and useful tools are included, along with links to relevant online resources.
Action: establish STP/ICS system lead
Establish a system executive lead with accountability to the sustainability and transformation partnership (STP)/integrated care system (ICS).
- GNBSI senior responsible officer letter – A letter from the NHS national medical director and chief nursing officer, requesting that each NHS system appoints a senior responsible officer (SRO) for antimicrobial stewardship.
- Example job description – system director of infection prevention and control – An example job description for a system director of infection prevention, who is also an SRO. While this role is full-time, elements of the job description might be removed and used to describe the SRO role (provided by Kent and Medway STP).
- Example role description – system director of infection prevention and control – A leadership proposal for system-wide infection prevention provision (provided by Kent and Medway STP).
Action: establish vision and goals
Draft and agree a vision and goals for the governance and leadership of the project.
- Driver diagram re: E. coli reduction (LCC) – An example driver diagram regarding drivers for E. coli reduction (provided by Lancashire County Council).
- Driver diagram for delivering 50% Gram-negative infection reduction – An example driver diagram for delivering 50% Gram-negative infection reduction.
- Driver diagram from Leeds Teaching Hospitals re E coli reduction – An example driver diagram from a provider regarding E. coli reduction (provided by Leeds Teaching Hospitals NHS Trust).
- Aligning with strategic aims – guidance on alignment with strategic aims.
- Lancashire County Council E. coli strategy – The E. coli strategy of Lancashire County Council (online pdf).
Action: develop a plan
Form a collaborative of system leads to develop a project plan.
- Stakeholder analysis tool – Tools to help identify and engage with stakeholders as part of the project.
- Patient storytelling toolkit – (Provided by Shropshire Community Health NHS Trust)
- Suggested terms of reference – Example terms of reference for a whole health system antimicrobial resistance and infection prevention and control meeting (provided by Kent and Medway STP).
- Plan on a page – An example ‘plan on a page’ document (provided by Bath and North East Somerset, and Wiltshire ICB).
Action: analyse data
Analyse available data to consider economic impact, and impact on morbidity and mortality.
- Economic tool to assist trust and ICS planning – An indicative tool showing NHS providers and commissioners how many infections are happening, the length of time patients stay in hospital, how many deaths are associated with E. coli, and the financial cost to the NHS.
Action: share outcomes
Share outcomes of above actions – vision and goals, project plan, economic analysis – with all system boards and governing bodies (including providers, ICSs and public health organisations).
Action: set up governance and reporting structure
Establish governance structure and system reporting into the STP/ICS, and link with prevention workstreams, as outlined in the NHS Long Term Plan.
- Kent and Medway governance structure – An example governance structure (provided by Kent and Medway STP).
- Cornwall and IoS governance structure – An example governance structure (provided by Cornwall and the Isles of Scilly Health and Care Partnership STP).
- Frimley ICS op plan – An example operating plan (provided by Frimley Health and Care ICS).
Action: plan for in-depth analysis
Make preparations for further, in-depth system and provider analyses to be carried out.
Action: develop a communications plan
Consider outcomes of all above actions and prepare a communications plan.
- Template comms plan – Template communications plan.
- Example comms plan – Example communications plan (provided by Buckinghamshire, Oxfordshire and Berkshire West ICS).
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