Hand hygiene and infection in hospitals: what do the public know; what should the public know?

Healthcare-associated infection (HCAI) is a topic of increasing public interest, particularly to users of health services. At the same time, there is a move towards greater openness and transparency across the whole healthcare sector. Thus we see public reporting of performance in relation to rates of HCAI and infection control practices is increasingly well established in the NHS in England. So does any of this make a difference? And how embedded is the 'public right to know'? In this paper it is argued that, although the public right to know about rates of HCAIs is well recognised, the evidence base about the impact of such information is limited. The paper suggests actions which can be taken by boards and senior leaders in healthcare organisations to increase impact. Furthermore the example of hand hygiene suggests that we have some way to go in creating an environment in which patients feel empowered to ask questions that may reduce their own vulnerability to infection.