Reducing Gram-negative bloodstream infections — governance and leadership

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Actions to ensure system structures and processes work to reduce Gram-negative bloodstream infections (GNBSI). Examples of good practices and useful tools are included, along with links to relevant online resources.

Action: establish STP/ICS system lead

Establish a system executive lead with accountability to the sustainability and transformation partnership (STP)/integrated care system (ICS).

GNBSI senior responsible officer letter PDF, 41.4 KB

A letter from the NHS national medical director and chief nursing officer, requesting that each NHS system appoints a senior responsible officer (SRO) for antimicrobial stewardship.

Example job description - system director of infection prevention and control DOCX, 59.8 KB

An example job description for a system director of infection prevention, who is also an SRO. While this role is full-time, elements of the job description might be removed and used to describe the SRO role (provided by Kent and Medway STP).

Example role description - system director of infection prevention and control DOCX, 53.4 KB

A leadership proposal for system-wide infection prevention provision (provided by Kent and Medway STP).


Action: establish vision and goals

Draft and agree a vision and goals for the governance and leadership of the project.

Driver diagram re: E. coli reduction (LCC) PNG, 160.0 KB

An example driver diagram regarding drivers for E. coli reduction (provided by Lancashire County Council).

Driver diagram for delivering 50% Gram-negative infection reduction PNG, 158.0 KB

An example driver diagram for delivering 50% Gram-negative infection reduction.

Driver diagram from Leeds Teaching Hospitals re E coli reduction DOCX, 54.7 KB

An example driver diagram from a provider regarding E. coli reduction (provided by Leeds Teaching Hospitals NHS Trust).

NHSIE document re aligning with strategic aims DOCX, 12.7 KB

NHS England and NHS Improvement guidance on alignment with strategic aims.


Action: develop a plan

Form a collaborative of system leads to develop a project plan.

Suggested terms of reference DOCX, 42.4 KB

Example terms of reference for a whole health system antimicrobial resistance and infection prevention and control meeting (provided by Kent and Medway STP).

Plan on a page PNG, 156.7 KB

An example 'plan on a page' document (provided by Bath and North East Somerset, and Wiltshire CCGs).


Action: analyse data

Analyse available data to consider economic impact, and impact on morbidity and mortality.


Action: share outcomes

Share outcomes of above actions - vision and goals, project plan, economic analysis - with all system boards and governing bodies (including providers, CCGs and public health organisations).


Action: set up governance and reporting structure

Establish governance structure and system reporting into the STP/ICS, and link with prevention workstreams, as outlined in the NHS Long Term Plan.

Kent and Medway governance structure PPTX, 1.0 MB

An example governance structure (provided by Kent and Medway STP).

Cornwall and IoS governance structure PPTX, 176.4 KB

An example governance structure (provided by Cornwall and the Isles of Scilly Health and Care Partnership STP).

Frimley ICS op plan PDF, 1016.0 KB

An example operating plan (provided by Frimley Health and Care ICS).


Action: plan for in-depth analysis

Make preparations for further, in-depth system and provider analyses to be carried out.


Action: develop a communications plan

Consider outcomes of all above actions and prepare a communications plan.

Template comms plan XLSX, 12.9 KB

Template communications plan.

Example comms plan DOCX, 1.1 MB

Example communications plan (provided by East Berkshire CCG).


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