Derby Family Medical Centre
13/10/2025
Annual Statement for Infection Prevention and Control (Primary Care) It is a requirement of The Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance that the Infection Prevention and Control Lead produces an annual statement regarding compliance with good practice on infection prevention and control and makes it available for anyone who wishes to see it, including patients and regulatory authorities.
As best practice, the Annual Statement should be published on the Practice website. The Annual Statement should provide a short review of any:
• Infection transmission incidents and any action taken (these will have been reported in accordance with our significant event procedure).
• Details of any infection control audits undertaken, and actions undertaken.
• Details of any risk assessments undertaken for prevention and control of infection.
• Details of staff training.
• Any review and update of policies, procedures, and guidelines.
Purpose
This annual statement will be generated each year in October, in accordance with the requirements of the Health and Social Care Act 2008 Code of Practice on the prevention and control of infections and related guidance. The report will be published on the practice website and will include the following summary:
- Any infection transmission incidents and any action taken (these will have been reported in accordance with our significant event procedure)
- Details of any infection control audits carried out, and actions undertaken
- Details of any risk assessments undertaken for the prevention and control of infection
- Details of staff training
- Any review and update of policies, procedures, and guidelines
Infection Prevention and Control (IPC) lead
The lead for infection prevention and control at Derby Family Medical Centre is Rachel Wilson, Practice Nurse.
The IPC lead is supported by Dr Nasser Zaman and Practice Manager Aneesa Ajaib.
- Infection transmission incidents (significant events)
Significant events involve examples of good practice as well as challenging events.
Positive events are discussed at meetings to allow all staff to be appraised in areas of best practice.
Negative events are managed by the staff member who either identified or was advised of any potential shortcoming. This person will complete a Significant Event Analysis (SEA) form which commences an investigation process to establish what can be learnt and to indicate changes that might lead to future improvements.
All significant events are reviewed and discussed at several meetings each month. Any learning points are cascaded to all relevant staff where an action plan, including audits or policy review, may follow.
In the past year, there have been 0 significant events raised which related to infection control. There have also been 0 complaints made regarding cleanliness or infection control.
- Infection prevention audit and actions
In addition to the annual IPC audit, the IPC Lead conducts monthly audits.
The Annual Infection Prevention and Control audit was completed by Rachel Wilson in October 2025.
The issues arising from these audits have been addressed and the following actions taken.
As a result of the audit, the following things have been changed in Derby Family Medical Centre:
- Domestic metal bins have now been replaced with plastic pedal bins.
- A new cleaning policy/poster will be introduced for the baby changing unit in the female toilets.
- Deep cleaning of the carpets and vinyl floors will be undertaken in November 2025.
- Regular audits with cleaning teams to highlight any issues and maintain high standards.
- Regular stock check in each clinical room including rotation of stock to help reduce excess stock, also ensuring staff will always have the correct items, at the correct time, in the correct quantity and create a clean safe environment for effective care to be delivered. This improves the patient experience and is cost effective.
- Curtains changed every twelve months in all clinical areas.
- Twice a day temperature checks on all fridges and weekly download of temperature data to the shared drive.
- Handwashing teaching is carried out annually for all staff members. Particular attention is drawn to technique which was observed in all team members and bare below the elbow’s guidelines.
- Handwashing audits are carried out by the IPC lead for all clinical staff. The hand washing audit/technique is completed on a rolling rota.
Derby Family Medical Centre will undertake the following audits in 2025/2026
• Annual Infection Prevention and Control audit
• Regular Infection Control room audits
• Clinical waste audit
• Hand hygiene audit and Sharps Bin audit
• Updating the staff vaccination matrix
c. Risk assessments
Risk assessments are carried out so that any risk is minimised and made to be as low as is reasonably practicable. Additionally, a risk assessment that can identify best practice can be established and then followed.
In the last year, the following risk assessments were carried out/reviewed:
- General IPC risks
- Staffing, new joiners and ongoing training
- COSHH
- Cleaning standards
- Privacy curtain cleaning or changes
- Staff vaccinations
- Infrastructure changes
- Sharps
- Water safety
d. Training
In addition to staff being involved in risk assessments and significant events, at Derby Family Medical Centre, all staff and contractors receive IPC induction training on commencing their post.
All staff receive infection prevention and control training via eLearning.
The IPC and Deputy IPC Leads complete annual training.
Clinical staff undertake this training at Level 2 and non-clinical complete Level 1.
This is repeated every 3 years:
Level 1: Behaviours expected by people at this level.
a. Staff ensure good IPC practice is appropriately embedded into their work.
b. Staff ensure their actions minimise risks to health and safety and contribute to positive and safe practice.
Level 2: All staff working directly with/providing care to patients and/or who work in the patient environment. Behaviours expected by people at this level (in addition to Level 1):
a. Staff assess risks related to IPC in the workplace and take appropriate actions.
b. Staff provide safe and effective care to patients as appropriate to the scope of their role.
c. Staff provide optimal IPC practice as an integral part of their day-to-day working.
This is repeated every three years. Strengthening IPC knowledge skills and behaviours across all health and social care sectors is important to support the provision of safe and effective care and deliver on the actions outlined in the NHS Long Term Plan (2019) and the Five-year Antimicrobial Resistance (AMR) National Action Plan (2019).
Face-to-face updates in Infection Prevention and Control are delivered annually.
We distribute any IPC updates via email and clinical meetings.
These updates raise awareness and alert to latest guidance.
e. Policies and procedures
The infection prevention and control-related policies and procedures that have been written, updated, or reviewed in the last year.
Policies relating to infection prevention and control are available to all staff and are reviewed and updated annually. Additionally, all policies are amended on an ongoing basis as per current advice, guidance, and legislation changes.
f. Antimicrobial prescribing and stewardship
The goal of the antimicrobial prescribing and stewardship (APS) is to improve the quality of antimicrobial treatment and stewardship and therefore reduce the risks of inadequate, inappropriate, and adverse effects of antimicrobial treatment. This will improve the safety and quality of patient care and make a significant contribution to the reduction in the emergence and spread of antimicrobial resistance (AMR).
Antimicrobial stewardship is an important element of the following:
• code of practice in England
• UK 20-year vision for AMR
• UK 5-year action plan for AMR
g. Responsibility
It is the responsibility of all staff members at Derby Family Medical Centre to be familiar with this statement, and their roles and responsibilities under it.
g. Review The IPC lead and Practice Manager are responsible for reviewing and producing the annual statement.