Infection Control Statement

Infection prevention and control (IPC) Annual Statement 

Dec 2023 – Dec 2024


In line with the Health and Social Care Act 2008: Code of practice on prevention and control of infection (July 2015) and its related guidance, this Annual Statement will be generated each year. It will summarise:

  • Any infection transmission incidents and any lessons learnt and action taken.
  • Details of any infection prevention and control (IPC) audits undertaken and any later actions taken arising from these audits
  • Details of any issues that may challenge infection prevention and control including risk assessment undertaken and subsequent actions implemented as a result.
  • Details of staff IPC training
  • Details of review and update of IPC policies, procedures, and guidance
  • To highlight priorities for the upcoming year.


Infection Lead is the first point of contact for practice staff in respect of Infection Control issues. He helps to create and keep an environment which will ensure the safety of the patient / client, carers, visitors and health care workers in relation to Healthcare Associated Infection (HCAI).

The Infection Control Lead carry out the following within the practice:

  • Increase awareness of Infection Control issues amongst staff and clients
  • Help motivate colleagues to improve practice.
  • Improve local implementation of Infection Control policies.
  • Ensure that practice-based Infection Control audits are undertaken.
  • Assist in the education of colleagues.
  • Help identify any Infection Control problems within the practice and work to resolve these, where necessary in conjunction with the local Infection Control Team and act as a role model within the practice
  • Disseminate key Infection Control messages to their colleagues within the practice.

Our Practice Infection Control Lead are Dr J S Trivedi & Dr Jigar Trivedi (GP Partners)

Infection Control Assistant: Numrata Suba (Practice Nurse)
Cleaning and Decontamination Lead: Minaxi Trivedi (PM)/ Amit Desai/Senior administrator 

No significant events reported regarding infection control issues in the period covered by this report.


The following audits/ assessments were carried out in the practice.

  • Infection controls annual audit completed- April 2023
  • Handwashing Audit - ongoing
  • PPE audit - ongoing
  • Infection Control Risk assessment - ongoing 
  • Vaccine storage control - Ongoing

Audit Key findings

  • Infection control audit
  • Site cleaning and waste policies in place and procedures being followed.
  • Appropriate Contracts in place to ensure clinical waste, confidential waste and regular waste are disposed of appropriately.
  • Site is appropriate for use and configured to allow easy cleaning in clinical areas.
  • Good provision of hand washing facilities throughout the clinic
  • Hand hygiene audit
  • Good compliance and awareness of hand hygiene policy
  • Printed guides/Poster available at sinks
  • Control of Legionella
  • Hot and Cold-water checks and maintenance completed weekly basis.
  • Risk of legionella completed By Salvum Ltd (Until May 2024)
  • All initial checks and system in place


Staffs are completing infection control training through the Blue stream training portal, this is renewed annually and audited through the blue stream module. Currently 50% of the expected 100% of staff have completed this training within the last 12 months, with 100% have completed some form of infection control training in the last 24 months.

Due to recruitment and new staff NOT, all staff have attended Infection Control refresher training in the last 1 year. Both infection Control Leads for the Practice have attended Infection Control training in the last year.

Our nurses are performing regular cleaning of communal areas and our clinicians routinely clean their space, and hands in-between appointments. The Equipment used by the clinical staff is a single use/handed.


The Policies below have been updated this Year. They are reviewed annually or earlier when appropriate due to changes in regulations and evidence-based guidance.

  • Home visit IPC policy
  • Clinical waste policy
  • Cleaning protocol
  • All cleaning schedules updated.


Site Improvements/ Audit recommendations

  • To continue to work with the cleaner to maintain expected standards of cleanliness.
  • Ongoing work to assess new staff immunisation status.
  • Revision of roles and responsibilities of infection control lead to reflect any changes
  • Continue rolling programme of audit, risk assessment and policy update



  • To ensure all staff within the next 3 month complete any training to ensure that infection control training is completed every 12 months to ensure all are kept up to date
  • Add infection and cleaning issues to monthly steps in house meeting 
  • Publish annual statement on website

SMC - Infection Control Yearly Statement 2023


An annual infection control statement/audit is generated each year by SMC / Shreeji Medical Centre.

It summarises:

  • Any infection transmission incidents and actions taken (these will be reported in accordance with our Significant Event procedure)
  • The annual infection control audit summary and actions undertaken
  • Control risk assessments undertaken
  • Details of staff training (both as part of induction and annual training) with regards to infection prevention & control
  • Details of infection control advice to patients
  • Any reviews and update of policies, procedures and guidelines


Shreeji Medical Centre Leads for Infection Prevention/Control (IPC) are Dr J S Trivedi and Dr Jigar Trivedi. 

Our IPC leads keep up to date with infection prevention & control practice and share necessary information with staff and patients throughout the year. 

Significant events 

In the past year there have been no significant events as regards infection control. 


An infection control yearly audit was undertaken in April 2023. As part of our recommendations, we emphasised that all staff clinical and non-clinical to complete their training.

Half- Yearly hand hygiene audit was conducted for all clinical staff, and they have met the standards. Monthly in-house cleaning audit was conducted and cleaner’s work and checklists are up-to-date.

Risk Assessment 

Regular risk assessments are undertaken to minimise the risk of infection and to ensure the safety of patients and staff.

Risk assessments also include COSHH assessment. 

Staff Training 

Inflection control training for clinical staff and non-clinical staff is up to date. SMC IPC leads, and relevant clinical staff also attend PC Champions training sessions offered by ICB. 

As part of SMC IPC policy our IPC leads regularly engage with practice staff to develop systems and processes that lead to sustainable and reliable improvements in applying infection prevention and control practices.

SMC has suitably qualified infection prevention and control staff who can provide expert advice on applying infection prevention and control in all care settings and on individual risk assessments, ensuring action is taken as required.

As per NHS national and ICB guidance we have epidemiological/surveillance systems capable of distinguishing patient case(s) requiring investigation and control.