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How widely has ANTT been adopted in NHS hospitals and community care organisations in England and Scotland?

10 September 2020
Volume 29 · Issue 16



To the detriment of patient safety, the important clinical competency of aseptic technique has been notoriously variable in practice, and described ambiguously in the literature, internationally. From a UK perspective, attempts have been made to improve patient safety by reducing variability and improving education and practice through standardisation. The Welsh Government mandated Aseptic Non Touch Technique (ANTT®) as a specific national standard in 2015. All healthcare organisations in England are required by the Health and Social Care Act 2008 to have a single standard aseptic technique, demonstrable by the clinical governance indicators of education, training, competency assessment and compliance audit. In Scotland, an education-based initiative was launched by NHS Education for Scotland in 2012. To review the impact of these and other initiatives on the current status of aseptic technique, all NHS trusts in England and NHS health boards in Scotland were assessed under the Freedom of Information procedure.


93% of NHS trusts in England use a single standard for aseptic technique. In 88% of these trusts the single standard was stipulated as being ANTT. In Scotland, 62% of NHS acute and community care hospitals within health boards use a single standard. In 56% of these, the single standard was ANTT. When including those that use ANTT in combination with other techniques ANTT usage is 73%.


These data demonstrate significant progress in standardising aseptic technique education, assessment and governance, and confirms ANTT as the de facto aseptic technique used in NHS trusts in England and health boards in Scotland.

Aseptic Non Touch Technique (ANTT®) was the first, and is still the only, complete clinical practice framework for aseptic technique shared widely in the UK and internationally (Association for Safe Aseptic Practice (ASAP), 2019) (Box 1). Its use provides healthcare organisations and patients with the advantages afforded by a single practice standard for aseptic technique. Such advantages include less practice variability, a common practice language and shared understanding for improved education and research. Developed in the late 1990s (Rowley, 2001), ANTT is now referenced, endorsed and used extensively in many healthcare sectors around the world (Rowley and Clare, 2019). For example, it is used in Ireland (Health Service Executive, 2011), Wales (Welsh Government, 2015), and Australia (National Health and Medical Research Council (NHMRC), 2019). It is also recommended in the USA by the Association for Vascular Access (AVA) (2019).

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