MRSA Action UK: Government guilty of taking their eye off the ball on hospital bugs

Friday, 12 June 2009 12:00 AM

The National Audit Office report into progress in tackling healthcare associated infections has revealed what the National Charity MRSA Action UK has been saying for months.

Despite the great efforts being made in many NHS Acute settings there is still a long way to go before we can say the endemic spread of healthcare associated infections has been quelled.

The postcode lottery remains and many hospitals are seeing dramatic increases in deadly infections. In April we reported that 22 Acute hospital areas were seeing a rise in infections, and worryingly this was happening outside of the Acute hospital setting.

MRSA Action UK fears that with cuts to budgets in community hospitals where investment is badly needed this worrying trend may well continue. We know that technology is now contributing to reducing infections, the Design Bugs Out programme was welcomed by patient groups and hospitals, sadly without investment being made across the healthcare setting we will continue to see people moving between care settings being exposed to environments that are not conducive to reducing infections. The estimated saving of between £141 million and £263 million made by reducing infections nationally must be reinvested in preventing further infections across the board.

Hand washing remains a challenge for some, with patients observing doctors in particular not following guidance on bare-below-the elbow and not adhering to key moments for hand hygiene. Poor recording of antibiotic prescribing and resistance in hospitals is also a significant concern, we are much better at it in the community setting and hospitals should learn from their peers.

Our campaign to record and publish more than the MRSA bloodstream infections is backed by the National Audit Office findings. There are indeed many infections that go largely unreported and unmeasured. You cannot reduce infections if you are not measuring infections, you cannot measure infections if you are not recording therefore you cannot improve performance. Surgical site infections, urinary tract and catheter infections account for significant number of people who become ill with infections and sadly die. These drop below the radar in the government figures and should be published. MSSA also contributes significantly to the burden on the system and the suffering it causes to patients. Methicillin resistant strains have not actually displaced methicillin susceptible strains: all they done are adding considerably to the burden of disease.

We have asked that the Department of Health consider stepped targets for hospitals who are not improving at the same rate as the top performers, so that the focus can be put onto bringing about the culture change needed to drive a zero tolerance ethos into the failing hospital trusts.

Whilst the "can do attitude" is one of the biggest factors in driving improvement, it cannot be done unless staff are well resourced, both in terms of investment in the environment and staff numbers, but also in terms of the skills needed.

With greater powers than its predecessors, the Care Quality Commission has a major role in helping to maintain the drive to reduce infections. Our charity's hope is that the regulator will work with the poor performing trusts. Where trusts fail to maintain year on year reductions the Care Quality Commission must use swift enforcement. This should not disrupt services to patients; if Boards and Senior Executives are culpable then they should be replaced by those who are competent.

Monitor must make better use of patients' views and ensure that Foundation Trusts are truly engaging with their local communities to avoid future tragedies such as the deaths and suffering at Mid Staffordshire NHS Foundation Trust.

The Department of Health's Cleaner Hospital Programme has listened to our concerns and Improvement Teams are working with poorer performing trusts to drive improvements in infection rates. The policy makers and the regulators must continue to work together for the benefit of patients.

This really is an "all or nothing affair" and everyone should have access to clean, safe care, wherever they live, the postcode lottery must end.

Derek Butler
Chair
MRSA Action UK
Registered Charity No.1115672

http://mrsaactionuk.net
Derek.butler@mrsaactionuk.net
07762 741114

Related articles:

MRSA Action UK: The latest MRSA figures show the postcode lottery remains
Friday, 20, Mar 2009

MRSA Action UK: Significant rise in the numbers of people contracting C.diff in 22 Acute Hospital Trust areas
Friday, 17, Apr 2009

MRSA Action UK: How the Department of Health can improve the way MRSA and Clostridium Difficile is reported
Wednesday, 13, May 2009

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