Infection Prevention and Control in General Practice: A Practical CQC Guide and Checklist

Infection Control in Practice

Infection prevention and control (IPC) is a fundamental part of providing safe healthcare in general practice. From hand hygiene and clinical waste management to cleaning schedules, staff training and sharps safety, GP practices need systems that reduce the risk of infection and demonstrate that those systems work in practice.

For CQC-registered GP practices in England, infection prevention and control is particularly relevant to Regulation 12: Safe care and treatment and Regulation 15: Premises and equipment.

However, good IPC is about much more than having an infection control policy sitting in a folder.

The Care Quality Commission (CQC) expects practices to have appropriate systems, leadership, training, risk assessments, audits and evidence that infection prevention measures are being implemented effectively.

This guide explains the key requirements for infection prevention and control in general practice, what practices should consider when preparing for CQC assessment and provides a practical GP practice infection control checklist.

What is infection prevention and control in general practice?

Infection prevention and control refers to the policies, procedures and everyday working practices used to prevent or reduce the transmission of infection.

The Health and Social Care Act 2008 Code of Practice on the prevention and control of infections states that effective infection prevention must form part of everyday practice and be applied consistently by everyone.

This is particularly important in general practice because staff regularly come into contact with patients who may have infectious illnesses, sometimes before an infection has been identified.

Standard infection control precautions should therefore be applied according to the risks associated with the patient, procedure and potential exposure.

Examples include:

• hand hygiene

• respiratory and cough hygiene

• appropriate use of personal protective equipment (PPE)

• safe management of clinical equipment

• environmental cleanliness

• safe handling of blood and body fluids

• appropriate management of linen

• safe disposal of healthcare waste

• safe management of sharps

• managing occupational exposure risks.

  
  

Effective IPC protects patients, staff, visitors and other people using the service.

What does CQC expect from GP practices?

CQC's GP Mythbuster 99: Infection prevention and control in General Practice provides useful guidance about the arrangements inspectors may consider.

Practices should have an effective IPC policy that is relevant to their service, accessible to staff and regularly reviewed.

CQC states that the policy should include areas such as:

• contact details for the local infection prevention and control specialist team

• requirements for higher-risk procedures such as minor surgery and fitting contraceptive devices

• staff IPC training requirements and frequency

• appropriate use and disposal of PPE

• responsibility for cleaning specific clinical equipment.

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Importantly, the practice should also have a named IPC lead with sufficient authority to implement improvements when problems are identified.

Having a named lead is not enough on its own. There should be evidence that IPC is actively managed.

The Health and Social Care Act 2008 Code of Practice

One of the most important reference documents for infection control in general practice is the Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance.

The Code contains ten criteria against which CQC can consider how providers comply with infection prevention and cleanliness requirements.

For primary medical care, these principles include having effective systems for managing IPC, maintaining a clean environment, supporting appropriate antimicrobial use, managing infection risks, having suitable policies and protecting staff from occupational infection risks.

The Code also recommends an annual IPC statement. This can provide useful evidence of how infection control has been managed during the year.

An annual IPC statement might summarise:

• significant infection control events

• learning and actions arising from incidents

• IPC audits completed

• actions arising from audits

• infection control risk assessments

• staff IPC training

• policy and procedure reviews

• improvements made to the premises or equipment.

  
  

Rather than viewing the annual statement as another piece of paperwork, practices can use it as an opportunity to demonstrate continuous improvement.

Appoint an infection prevention and control lead

Every GP practice should have clear leadership for infection prevention and control.

The IPC lead should understand their responsibilities and have sufficient authority to raise concerns and make changes.

Their responsibilities might include:

• coordinating IPC audits

• reviewing the IPC policy

• monitoring cleaning standards

• identifying IPC risks

• reviewing significant events involving infection control

• ensuring actions are completed

• supporting staff training

• maintaining awareness of changes to national guidance

• producing or contributing to the annual IPC statement.

Practices should also consider what happens when the IPC lead is absent and how staff can access specialist IPC advice when required.

Infection control policies

A common compliance mistake is treating the IPC policy as the evidence that infection control is effective. A policy only describes what should happen.

CQC will be interested in whether those arrangements are actually happening.

The IPC policy should reflect the activities undertaken by the individual practice rather than being a generic template that bears little relationship to the service.

It should also be reviewed regularly and updated following changes to guidance, services or identified risks.

For example, a practice performing minor surgery may require additional procedures and risk controls compared with a practice that does not undertake invasive procedures. Policies should clearly identify ownership, review arrangements and responsibilities.

IPC audits in general practice

An effective infection prevention and control audit programme is an important part of demonstrating good governance.

CQC expects practices to have an audit programme that provides assurance that policies and procedures remain effective and up to date. However, completing an audit is only the first stage. If an audit identifies concerns, the practice should demonstrate what happened next.

A simple audit trail could be:

Audit → Issue identified → Action agreed → Responsible person appointed → Target date → Action completed → Re-audit or review

For example, an audit might identify that a treatment room chair has damaged upholstery that can no longer be cleaned effectively.

The practice could record the issue, assess the risk, arrange replacement or repair and record when the action has been completed. This provides much stronger evidence than simply producing a completed IPC audit.

Cleaning and environmental cleanliness

GP practices need to provide and maintain an environment that facilitates effective infection prevention and control.

The National Standards of Healthcare Cleanliness 2025 are now referenced by CQC and replaced the previous 2021 cleanliness specifications.

Cleaning arrangements should reflect the risks associated with different areas of the practice.

A cleaning schedule should identify:

• what needs cleaning

• how frequently it should be cleaned

• how it should be cleaned

• who is responsible

• how compliance is monitored.

Frequently touched surfaces should not be overlooked.

Examples include:

• door handles

• keyboards

• telephones

• light switches

• examination couches

• clinical work surfaces

• reusable equipment.

Where external cleaning contractors are used, practices should still have arrangements for checking that cleaning has been completed to the expected standard. Outsourcing cleaning does not remove the provider's responsibility for ensuring the premises are safe.

Carpets, curtains and blinds

There are several misconceptions around what CQC expects regarding carpets and curtains. CQC states that clinical rooms should not have carpets.

Where carpets are present in consulting rooms or communal areas, the practice should have a cleaning policy that explains routine cleaning arrangements and what happens if the carpet becomes contaminated by blood or other body fluids.

Similarly, CQC does not specify a universal mandatory frequency for changing examination curtains.

Practices should assess the risk and establish their own protocol. Curtains should, however, be changed immediately when visibly soiled or stained. The important principle is therefore risk assessment and evidence of an appropriate cleaning system, rather than following an arbitrary replacement date.

Hand hygiene

Hand hygiene remains one of the most important infection prevention measures.

Practices should provide suitable and accessible handwashing facilities.

CQC guidance identifies the need for:

• liquid soap

• paper towels

• alcohol hand rub

• appropriate PPE.

Staff should understand correct hand hygiene technique and know when handwashing or alcohol hand rub is appropriate. Hand hygiene should also form part of staff IPC training. Practices may wish to include observation of hand hygiene technique within their IPC audit programme rather than relying solely on staff completing online training.

Personal protective equipment

PPE should be selected according to the risk associated with the task being performed.

Depending on the procedure, this may include:

• disposable gloves

• disposable aprons

• masks

• eye or face protection.

Staff should understand when PPE is required, how to put it on and remove it safely, and how it should be disposed of. Simply having boxes of gloves and aprons available does not demonstrate effective infection control.

Training and correct use are equally important.

Clinical equipment

Reusable clinical equipment can become a source of infection if it is not appropriately cleaned and maintained.

The practice should clearly define who is responsible for cleaning equipment.

This might include:

• examination couches

• blood pressure cuffs

• pulse oximeters

• thermometers

• ECG equipment

• weighing equipment

• reusable examination equipment.

Manufacturer instructions should be considered when determining appropriate cleaning and decontamination methods.

Equipment should also be maintained appropriately, with servicing or calibration undertaken where required.

Healthcare and clinical waste

Healthcare waste must be managed safely from the point it is produced until its final disposal.

CQC refers practices to HTM 07-01: Safe Management of Healthcare Waste.

Waste should be correctly segregated according to the type of waste being produced.

Clinical waste bins should be readily accessible at the point of use. In clinical areas, CQC states that bins should have lids and be foot operated.

Waste bags should not be overfilled. CQC guidance states that bags should be securely tied when no more than two-thirds full and appropriately labelled before collection.

Waste awaiting collection should be stored in a secure, clean and designated location.

Practices should also ensure staff understand the different waste streams used within the service.

Sharps management

Sharps present both an infection and occupational safety risk.

Practices should assess which sharps containers are required according to the type of waste being produced.

Sharps containers should:

• be correctly assembled

• be labelled appropriately

• be positioned safely

• not be filled above the fill line

• be locked before disposal

• be disposed of through an appropriate waste stream.

Staff should also have clear guidance explaining what to do following a needlestick or sharps injury. This process should be readily accessible rather than hidden within a lengthy policy that staff cannot find during an incident.

The Health and Safety (Sharp Instruments in Healthcare) Regulations 2013 should also be considered when developing sharps safety arrangements.

Staff immunisation and occupational health

Protecting healthcare workers forms part of effective infection prevention and control.

Staff should have access to appropriate occupational health support and should be assessed according to their role and occupational exposure risks.

The practice should consider relevant recommendations within UKHSA's Green Book: Immunisation against infectious disease.

The Health and Social Care Act Code of Practice also highlights risk assessment for staff immunisation. Importantly, practices should be able to demonstrate that occupational risks have been considered rather than simply assuming that all employees require exactly the same arrangements.

Higher-risk procedures

Some procedures undertaken in general practice create additional IPC risks.

These might include:

• minor surgery

• wound care

• insertion or removal of contraceptive devices

• procedures involving exposure to blood or body fluids.

The IPC policy and associated procedures should reflect the actual services provided.

Risk assessments should consider the environment, equipment, PPE, aseptic technique, waste disposal and staff competence required for the procedure.

Infection risks and patient placement

GP practices are not generally expected to have dedicated isolation rooms.

However, the Health and Social Care Act Code of Practice expects primary medical care services to take reasonable precautions where a patient is suspected or known to have a transmissible infection.

Practices should therefore consider how potentially infectious patients are managed.

This could include:

• identifying infection risks when appointments are booked

• avoiding unnecessary time in crowded waiting rooms

• considering appropriate room placement

• applying respiratory hygiene measures

• using appropriate PPE

• cleaning affected areas following the consultation where required.

Arrangements should be proportionate to the level of risk.

Antimicrobial stewardship

Infection prevention and antimicrobial stewardship are closely linked.

Preventing infections reduces the need for antimicrobial treatment, while appropriate prescribing helps reduce antimicrobial resistance.

The Health and Social Care Act Code of Practice specifically includes appropriate antimicrobial use and stewardship.

Practices should therefore consider how they monitor prescribing and respond to antimicrobial stewardship initiatives and guidance.

Staff training

IPC training should form part of staff induction and ongoing training.

Training should be appropriate to the employee's role.

Topics may include:

• standard infection control precautions

• hand hygiene

• PPE

• sharps safety

• clinical waste

• blood and body fluid spillages

• cleaning and decontamination

• management of occupational exposure.

Practices should maintain evidence that training has been completed and consider how they assess whether staff can apply that training in practice.

What evidence might demonstrate good IPC governance?

When reviewing infection prevention and control, useful evidence could include:

• current IPC policy

• named IPC lead

• IPC audits

• completed audit action plans

• cleaning schedules

• cleaning monitoring records

• equipment cleaning arrangements

• IPC risk assessments

• staff training records

• occupational health arrangements

• staff immunisation risk assessments

• waste contracts and waste transfer documentation

• sharps procedures

• needlestick injury procedures

• relevant significant event reviews

• annual IPC statement.

The strongest evidence usually shows a complete governance cycle.

For example:

Risk identified → action taken → improvement demonstrated → ongoing monitoring established.

That tells a much stronger story than simply having a folder containing policies.

GP Practice Infection Prevention and Control Checklist

Use the following checklist or download it here as a simple starting point when reviewing IPC arrangements within your practice.

Leadership and governance

• Named IPC lead appointed.

• IPC lead understands their responsibilities.

• Current IPC policy is available to all staff.

• Policy reflects the services and procedures actually provided.

• Local IPC specialist contact details are available.

• IPC policies have defined review dates.

• Annual IPC statement is completed and retained.

• IPC risks are included within practice governance arrangements.

• Significant IPC incidents are reviewed and learning recorded.

Audit and monitoring

• Regular IPC audits are completed.

• Audit findings are documented.

• Actions have named responsible persons.

• Target completion dates are recorded.

• Completed actions are evidenced.

• Re-audits or follow-up reviews confirm improvements where necessary.

Environment and cleaning

• Cleaning schedule identifies areas, items and cleaning frequencies.

• Responsibilities for cleaning are clearly defined.

• High-touch surfaces are included.

• Cleaning standards are monitored.

• Clinical rooms do not have carpets.

• Appropriate arrangements exist for cleaning carpets elsewhere.

• Curtain and blind cleaning arrangements are documented.

• Visibly contaminated curtains are changed promptly.

• Clinical surfaces are intact and can be effectively cleaned.

Hand hygiene and PPE

• Clinical handwashing facilities are readily accessible.

• Liquid soap is available.

• Disposable paper towels are available.

• Alcohol hand rub is available where appropriate.

• Appropriate PPE is readily available.

• Staff understand correct hand hygiene technique.

• Staff understand appropriate PPE selection, use and disposal.

Clinical equipment

• Responsibilities for equipment cleaning are defined.

• Reusable equipment can be effectively cleaned.

• Manufacturer cleaning instructions are followed where appropriate.

• Equipment is maintained and serviced where required.

• Damaged equipment or surfaces that cannot be effectively cleaned are identified and addressed.

Waste and sharps

• Waste is appropriately segregated.

• Suitable waste containers are available at the point of use.

• Clinical bins are lidded and foot operated.

• Waste bags are not filled beyond recommended limits.

• Waste awaiting collection is securely stored.

• Appropriate sharps containers are available.

• Sharps containers are labelled correctly.

• Sharps containers are not filled above the fill line.

• Staff know what to do following a sharps injury.

• Healthcare waste arrangements comply with relevant guidance.

Staff safety and training

• IPC training forms part of staff induction.

• IPC refresher training is provided.

• Training records are maintained.

• Occupational health support is available.

• Staff infection and immunisation risks are assessed according to their role.

• Appropriate vaccinations are offered in line with national guidance.

Higher-risk clinical procedures

• IPC risks associated with minor surgery are assessed where applicable.

• IPC arrangements for contraceptive procedures are documented where applicable.

• Appropriate PPE is available.

• Aseptic procedures are understood by relevant staff.

• Appropriate arrangements exist for blood and body fluid spillages.

• Procedures for managing patients with suspected transmissible infections are in place.

Preparing for CQC: focus on evidence, not paperwork

One of the most important principles for practices preparing for CQC assessment is that infection prevention and control should be demonstrated rather than simply documented.

A practice could have an excellent IPC policy but still have poor infection control.

Equally, a minor problem identified during an audit does not necessarily indicate poor governance if the practice has recognised the issue, assessed the risk and taken appropriate action.

Practices should therefore regularly ask:

How do we know our infection prevention and control arrangements are working?

The answer should come from audits, observations, training, risk assessments, incident reviews and evidence that identified problems have resulted in improvement.

Good infection prevention and control is not an annual exercise undertaken before a CQC inspection. It should form part of everyday clinical governance and patient safety.

Need help preparing for CQC?

If you are reviewing infection prevention and control within your GP practice, preparing for a CQC assessment or want an independent review of your wider compliance arrangements, CQC Consultancy can help.

Our support can help practices identify gaps, understand CQC expectations and put practical improvements in place before problems become regulatory concerns.

Visit CQCconsultancy.net to find out more about our CQC compliance support, mock inspections and free CQC resources.

Further guidance

Practices should refer to the latest versions of relevant national guidance, including:

• Care Quality Commission: GP Mythbuster 99: Infection prevention and control in General Practice

• Department of Health and Social Care: Health and Social Care Act 2008: Code of Practice on the prevention and control of infections and related guidance

• NHS England: National Standards of Healthcare Cleanliness 2025

• NHS England: Standard Infection Control Precautions

• NHS England: HTM 07-01 Safe Management of Healthcare Waste

• UK Health Security Agency: Immunisation against infectious disease (The Green Book)

• NICE: Healthcare-associated infections: prevention and control in primary and community care

• Health and Safety Executive: Health and Safety (Sharp Instruments in Healthcare) Regulations 2013

Disclaimer: This article provides general information about infection prevention and control and CQC compliance in England. It should not be treated as legal, clinical or occupational health advice. Providers remain responsible for ensuring their arrangements meet current legislation, national guidance and the specific risks associated with their service.