Infection prevention and control in Scotland and Wales: HIS and HIW rules for providers

Infection prevention and control is written into the registration rules for independent healthcare in both Scotland and Wales, but the legal duty, the regulator and the detail differ. This guide covers independent hospitals, clinics and medical agencies, and points to the parallel duty for care homes and other care services. For England, see the Care Quality Commission's infection prevention and control guidance and the Healthcare infection prevention and control guide.

Which regime applies to you

• You provide an independent healthcare service in Scotland: register with Healthcare Improvement Scotland (HIS). Regulation 3(d)(i) of SSI 2011/182 requires systems, processes and procedures for the prevention and control of infection.
• You provide an independent healthcare service in Wales: register with Healthcare Inspectorate Wales (HIW). Regulations 9, 15 and 31 of WSI 2011/734 require a written infection control policy, protection against healthcare associated infection and outbreak notification.
• You run a care home or other care service: the Care Inspectorate (Scotland) or Care Inspectorate Wales applies its own regulation: regulation 4(1)(d) of SSI 2011/210 in Scotland and regulation 56 of WSI 2017/1264 in Wales.
• You are an NHS board or trust: the National Infection Prevention and Control Manual is mandatory in NHSScotland. NHS services are not registered by HIS or HIW.
• You operate in both nations: register and comply in each, separately. Registration in one gives you nothing in the other.

Scotland

Wales

The two regimes side by side

Steps to put infection prevention and control in place

1. Work out which regime covers each site. Register each service in the nation where it operates. Independent hospitals, private psychiatric hospitals, clinics, medical agencies and ambulance services in Scotland register with HIS. Independent hospitals, clinics and medical agencies in Wales register with HIW. Private dental practices in Wales also register with HIW, but under the Private Dentistry (Wales) Regulations 2017, which this guide does not cover.
2. Name who is accountable. In Scotland the duty is the provider's. In Wales it is the registered person's. It is good practice to record who leads infection prevention and control in the service.
3. Write the policy and the procedures. Cover hand hygiene, cleaning and housekeeping, decontamination of reusable equipment, management of clinical waste, standard infection control precautions and transmission-based precautions, and outbreak management. Base them on the National Infection Prevention and Control Manual.
4. Train your staff and keep a record. In Scotland the Regulations require training appropriate to each person's work (regulation 12). In Wales the policy must include relevant training and advice.
5. Check your premises and equipment. Premises must be fit and in good repair (regulation 10 in Scotland; the fitness of premises rule in Wales). HIS's application guidance points Scottish providers to Scottish Health Technical Memorandum 64 for clinical hand wash basins.
6. Set up the reporting route. In Wales, tell HIW within 24 hours of a serious outbreak and confirm any phone call in writing within 72 hours. In Scotland the Regulations contain no outbreak notification rule, so follow the incident and outbreak chapter of the National Manual and ask HIS if you are unsure what it expects you to report.
7. Review and keep evidence. In Wales, review policies at least every 3 years and keep every version for at least 3 years. In Scotland, keep evidence that your systems are followed, because HIS inspects against them.