The history of healthcare facilities management services: a UK perspective on infection control

Abstract

Purpose: The history of the development of non-clinical services in infection control (IC) dates back to the pre-modern era. There is evidence of healthcare facility management (HFM) services in Roman military hospitals. With the fall of the Roman Empire, Christian beliefs and teaching shaped the development of HFM in monastic hospitals. It was not until the late Victorian era that the link between HFM services and diseases caused by ‘miasma’, or bad air, became established. The discovery of bacteria in the modern scientific era reduced the level of importance previously attached to non-clinical causes of infections. Today, in the NHS, HFM services continue to be treated as though they had no real role to play in IC. This research collates historical and epidemiological evidence to show the link between HFM and IC.

Design/methodology/approach: The evidence gathered in this research paper is primarily based on an in-depth review of research from a wide range of sources. A ‘within-study literature analysis’ was conducted in order to synthesise the research materials. This involved the application of ‘between-source triangulation’ to verify the quality of the information contained in the studies, and ‘between-source complementarity’ to provide an in-depth elaboration of the historical facts.

Findings: Historical and epidemiological evidence shows that HFM services such as cleaning, waste management, catering, laundry and maintenance continue to play a crucial role in IC. This is corroborated by evidence gathered from the work of renowned pioneers in the field of infection control. However, reforms in the NHS have failed to consider this, as HFM services have been largely fragmented through different partnership arrangements. Practical implications: Among many other things, this research raises the profile of HFM staff in relation to the issue of IC in hospitals. It presents convincing evidence to show that the relationship between the clinical and non-clinical domains in controlling infections in hospitals has a long history. The findings of this research give HFM staff invaluable information about the significant role of their profession in the control of infections in hospitals.

Originality/value: This is one of the few studies examining the historical development of HFM services, as well as their contribution to IC. Other work in this area has mainly been framed from a clinical healthcare perspective.