The Citizen (UK)

HOSPITALS UNDER FIRE OVER INFECTION RATES

14.07.04

  
 Health service chiefs were today accused of sitting on their hands while superbugs go out of control in hospitals.

Hospital bugs are killing thousands of patients a year and are to come under attack in new proposals outlined by the Government this week.  But a report from the National Audit Office, published today, blamed poor working practices in hospitals and a continuing lack of cleanliness and hygiene for rising infection rates.

Superbugs like MRSA have reached epidemic levels and the Government wants to take the NHS back to the super-clean standards of the 1950s.

A multi-pronged attack on the "continual challenge" of life-threatening superbugs was unveiled by the Health Secretary John Reid.

Matrons and ward sisters will make sure staff wash their hands and keep wards clean, and patients will be able to phone staff from their beds to clean up mess that can spread infection.

Control would be passed to frontline ward staff and patients encouraged to speak out if they thought hygiene standards were slipping.

Experts from countries with low MRSA rates will also be flown in to pass on their knowledge, and are expected to stress the importance of isolating infected patients.

Dr Reid said checks were needed to make sure that, where services had been contracted out, cleanliness had not been substituted for cheapness.

He said: "Even if I had all the powers in the world at the moment I can't kill MRSA - because MRSA is methicillin-resistant. It is becoming resistant to the things which 10 or 15 years ago used to kill it. That is a major problem. We need frontline activity, we need a major effort, we need cleanliness and hygiene."

The NAO's report looked at how hospitals have tackled infections following its four-year study. It found numbers of hospital blood infections by the bug staphylococcus aureus had gone up eight per cent in England from 17,933 in 2001-02 to 19,311 in 2003-04. Of these, 40% were the potentially deadly MRSA (methicillin- resistant staphylococcus aureus) strain that is resistant to most known antibiotics.

British hospitals are said to have one of the worst MRSA infection rates in Europe.

The NAO said despite new measures designed to bring hospital-acquired infections under control, little had changed on the ground since it first reported on the problem in 2000.

The NAO said more had to be done to improve working practices. In particular, it called for obligatory induction training in infection control for all hospital staff.

The NAO said there was still evidence hospital staff were not complying with hand-washing guidelines. But research had shown it was not simply a question of laziness or lack of awareness. Inadequate facilities, excessive workload and poor access to hand- hygiene agents were all factors.

A key obstacle to progress was the lack of information about the extent and cost of hospital-acquired infections, said the report. To try to combat this, local patients' forums will be responsible for cleanliness inspections four times a year.

Levels of cleanliness also contribute hospital star ratings, compiled from inspections carried out by the Healthcare Commission.

Hospital-acquired infections strike 100,000 people each year in England, resulting in an estimated 5,000 deaths.

MRSA first appeared in the 1960s but has reached epidemic levels in the last few years. Some strains are resistant to almost all known antibiotics, and fighting it already costs the NHS an estimated £1 billion a year.

MRSA cases are falling in Gloucestershire, with 40 in 2002-03, compared to 46 the previous year. Gloucestershire Hospitals NHS Trust had the 17th lowest rate of infection of the country's 111 general acute trusts and the lowest in the South West.

The trust appointed an MRSA "tsar" in March to deal with infection control and help enforce hygiene guidelines such as handwashing.

Barbara Marshall, vice chair of the county's Patient and Public Involvement Forum, who will inspect cleanliness levels under the new proposals, thought they were a good idea.

She said: "The forum is looking at how all infections, not just MRSA, are controlled through the hospitals, but I think these measures should help reduce infection levels."