Abstract：
In its first 2 decades, the NHS witnessed the near eradication of life-threatening community-acquired infections. However, medical advances have created different challenges (such as antimicrobial resistance and healthcare-associated infections) against a background of an increasingly ageing population. The recent COVID-19 pandemic has highlighted a lack of parity with regards to provision of NHS \'infection services\' (infectious diseases, microbiology and virology) across the UK, which urgently needs to be addressed. We recommend a fundamental review of NHS infection service provision: divided into four key areas. Firstly, there should be a consideration of a single multidisciplinary specialty of infection medicine removing barriers to training and service delivery. Secondly, streamline infection training via a single pathway through to certificate of completion of training, encompassing all aspects of infection service provision, for example, infection diagnostics, clinical care (including inpatient, outpatient and community based care), and infection prevention and control. There should be flexibility within the training curriculum to facilitate combined training with general internal medicine (GIM) as well as out of programme activities. Innovative ways of providing clinical experience should be considered, acknowledging the roles that medical microbiologists working closely with GIM colleagues in district general hospitals can play in managing patients with infections. Thirdly, formally commission a national network of specialised infectious diseases units with the creation of service standards. This can facilitate future pandemic resilience using a hub-and-spoke model utilising local infection expertise. Lastly, standardise the NHS framework to lead and coordinate development of integrated infection services at the local level.
摘要：
在最初的20年里，NHS见证了威胁生命的社区获得性感染的几乎根除.然而,在人口日益老龄化的背景下，医学进步带来了不同的挑战(如抗菌素耐药性和医疗保健相关感染)。最近的COVID-19大流行突显了在提供NHS“感染服务”(传染病，微生物学和病毒学）在英国，这是迫切需要解决的问题。我们建议对NHS感染服务的提供进行基本审查：分为四个关键领域。首先,应该考虑感染医学的单一多学科专业，以消除培训和服务提供的障碍。其次,通过单一途径简化感染培训，直至完成培训证书，涵盖感染服务提供的所有方面，例如,感染诊断，临床护理(包括住院，门诊和社区护理)，和感染预防和控制。培训课程应具有灵活性，以促进与普通内科（GIM）以及计划活动的联合培训。应考虑提供临床经验的创新方式，承认与地区综合医院GIM同事密切合作的医学微生物学家在管理感染患者方面可以发挥的作用。第三，正式委托全国专业传染病单位网络制定服务标准。这可以使用利用本地感染专业知识的中心辐射模型来促进未来的大流行抵御能力。最后,标准化NHS框架，以领导和协调地方一级综合感染服务的发展。
