Prevent Hospitals and Care homes becoming transmission centres

Institute a significant audit of all current hospital and care home internal and related external support operations. Published reports to be available to both management and staff - who may also provide valuable input and insight to such an audit process - as we move gradually into the next phases of containment and prevention. This would include :
- Staffing ....who needs to actually be in attendance and working from hospital buildings, and who can be facilitated to work from home ? GP practices and Health Centres in communities already facilitate good quality remote engagement with many patients - can the same principles be applied to larger hospital settings where greater numbers and denser concentrations of people interact ?
- Cleaning regimes ....how have these been upgraded since the Virus outbreak ? have they been effective ? what works best ? There is evidence from Europe that the virus is carried on the soles of shoes throughout hospitals, rendering the notion of Covid and Non-Covid areas completely ineffective. Do we have for example disinfectant mats at the entrances and exits to each ward and office within our health facilities ?
- Infection control measures....who is taking responsibility for ensuring these are effective for staff and patients who are a) Moving in and out of buildings , b) moving from Ward to Ward, c) moving from the Pharmacy in and out of Wards and, d) moving between eating and rest areas and Wards. Are these staff movements monitored, 'policed', reported on regularly in order to inform improvements to working practices ? Do we actually encourage a culture where we are continually learning and feeding back to support improvements aimed at lowering the potential impact of C-19 amongst staff and patients ?

Preventing our Hospitals and Care homes becoming themselves transmission vehicles is a lesson we need to learn from other countries where systems have been overwhelmed. We have been partially successful in reducing community transmission in Scotland, but more can be done to stamp down on potential infection routes related to our major Health facilities.
Measures such as those suggested can :
* Demonstrate that our NHS is stepping up it's actions to learn from, and improve on, actions taken to date in responding to a new viral threat
* Reduce potential morbidity amongst Hospital and Care home staff groups
* Reduce Virus transmission routes between hospitals and communities
* Give staff confidence that their concerns are taken on board and that workplaces are serious about making effective changes which protect both their health and wider public health.