How to Prevent the Spread of Germs in a GP Surgery

Yes, to an extent. By their very nature, it is impossible to prevent the spread of germs if there are no cleaning operations in place. This is why daily meticulous cleaning tasks are required. 

While it’s impossible to eliminate all germs, a well-implemented infection prevention and control (IPC) strategy can significantly reduce their transmission.

The strategy for preventing germ spread is multi-faceted, involving a combination of strict protocols, staff training, and environmental controls. Here are the methods GP surgeries can employ:

1. Hand hygiene

This is the single most important measure for preventing the spread of infection. Germs are most commonly transmitted via hands.

• Hand sanitiser and washing facilities: Alcohol-based hand sanitiser dispensers must be readily available throughout the surgery—in every consultation room, at the reception desk, and in waiting areas. Sinks with soap and water are also essential for situations where hands are visibly soiled.
• The “5 moments for hand hygiene”: Staff are trained to clean their hands at five key moments:

1. Before touching a patient.
2. Before a clean/aseptic procedure.
3. After a body fluid exposure risk.
4. After touching a patient.
5. After touching a patient’s surroundings.

2. Environmental cleaning and disinfection

Maintaining a clean physical environment is crucial, as germs can survive on surfaces for extended periods. Whilst briefer cleaning routines can take place during operational hours, deeper cleans are better to do after operating hours. For best results, consulting and collaborating with a professional cleaning service is a great option. 

Below is what the surgery should be implementing during their daytime cleaning:

• Routine cleaning: A strict cleaning schedule based on the “Functional Risk” of each area is followed. High-traffic and clinical areas are cleaned frequently, often with an intensive clean performed overnight.
• High-touch surface disinfection: Throughout the day, staff or a dedicated day cleaner disinfects “touchpoints” like door handles, light switches, payment terminals, and reception counters to prevent cross-contamination.
• Colour-coding: A non-negotiable legal requirement is the use of a colour-coded system for cleaning equipment to prevent germs from being spread from one area to another (e.g., using a red cloth only for toilets).

3. Use of PPE

PPE acts as a barrier between staff and germs, protecting both the wearer and the patient. Although visitors aren’t compelled to wear PPE, staff must wear the following when faced with specific situations:

• Gloves: Used for any task involving contact with bodily fluids, non-intact skin, or contaminated items.
• Aprons and gowns: Worn during procedures where there is a risk of splashes or contact with bodily fluids.
• Masks and eye protection: Used during procedures that may generate splashes or aerosols to protect the mouth, nose, and eyes.

4. Patient and staff education

A key part of prevention is ensuring everyone understands the risks and the protocols.

• Respiratory hygiene: Signage and posters encourage patients to cover their mouth and nose when coughing or sneezing, and to use the provided tissues and bins. Hand hygiene is also promoted for all visitors.
• Staff training: All staff must receive regular and up-to-date training on infection prevention and control (IPC) protocols. They must be aware of their specific responsibilities in maintaining a safe and clean environment.
• General hygiene reminders: Although it may seem obvious, some individuals are either unaware of or choose not to follow basic hygiene practices. For example, washing hands after using the bathroom. To address these issues, placing clear signage in the bathroom can help encourage better habits.

5. Facility design and management

How a surgery is designed and managed can also help prevent germ spread.

• Clear pathways and segregation: Clinical and non-clinical areas are separated to minimise traffic and the potential for contamination. Some surgeries have separate waiting areas for patients with infectious symptoms.
• Ventilation: Good ventilation systems help to circulate and filter air, reducing the concentration of airborne pathogens.
• Waste management: A strict system for segregating, storing, and disposing of clinical and non-clinical waste is in place to prevent the spread of germs from contaminated materials.

Can visitors help to prevent the spread of germs?

Yes. Although self-cleaning and responsibility for germ spreading is now very much an individual choice, visitors can easily help to prevent the spread of germs in the following ways when visiting a GP surgery:

• Sanitising hands upon entering the surgery, and after using doors etc.
• Washing hands after using the bathroom. 
• Wearing a mask if you are ill.
• Maintaining a distance from other individuals if possible (especially if you know you are unwell). 
• Wear clothes that cover your body. This helps to mitigate bodily fluids such as sweat from ending up on surfaces or furniture.