Dr Jennie Wilson, Associate Professor, University of West London
It is widely recognised that surveillance plays a key role in preventing healthcare associated infections and many local and National surveillance programmes have developed in recent decades. The experience of surveillance systems in UK and Europe illustrates how such programmes can be powerful drivers of change, even in environments where improvement appears impossible. None-the-less, surveillance can also distort activity and drive perverse behaviour. There are a number of critical underpinning characteristics that distinguish good and bad surveillance systems, and problems such as case definitions, post-discharge surveillance and data capture systems need to be addressed and their impact on rates carefully considered. Benchmarking is a key aim of national surveillance systems but creating systems for accurately and effectively comparing rates of HCAI is challenging. Locating surveillance within a wider programme of service improvement is essential to reducing HCAI and assuring patient safety.