Wednesday, 18 January 2012 8:45 AM
Patients believe the ambiguity in Health Minister Simon Burns’ statement that Trusts are “MRSA free” was misleading. Last week the statement made in the press release by the Department of Health proclaiming New Year ambitions to reduce healthcare associated infections, failed to impress members of MRSA Action UK.
MRSA Action UK was formed when cases of MRSA bloodstream infections were at an all time high. John Reid championed the patients’ cause when he set the target to half the numbers of people affected by the bloodstream infections on November 5th 2004. We had all been profoundly affected, some by losing someone we loved, others being left with continuing ill health as a consequence of encounters with the superbug. Many in the healthcare profession said it was not possible to be so ambitious to cut the numbers of people affected in four years. Well it was possible and this significant turnaround was achieved through the hard work and diligence of staff doing the right things to reduce the risks from contracting a bloodstream infection
The challenge that followed was for the NHS to ensure that the downward trend continued with a move to a position of zero tolerance to all avoidable infections.
It’s not just the bloodstream infections that we need to deal with, many of us that were affected know that those we lost did not even feature in the numbers, this is because these were surgical site infections, or infections in invasive devices. Medical records show that no blood cultures were taken, yet our loved ones died with organ failure and other complications caused by this micro-organism, and, for most of us, MRSA did not feature on the death certificate of those who passed away.
There are still many more infections that we need to include in the reporting, and if Simon Burns’ commitment to transparency is real, then it is not fair to present the inaccurate statement that there are growing numbers of Trusts that are “MRSA free”. This play on words is misleading and is not transparent.
We are disappointed at this statement. We do however welcome the ambition in the statement made by the Minister when he says:
”there is still more to do to before we have achieved our objective of zero tolerance for all avoidable healthcare associated infections”
We believe that in addition to our own experiences, that there is undercounting of the numbers of infections affecting people, as complications post discharge are not always recorded. If we take surgical site infections (SSIs) as an example, surveillance reports from the Health Protection Agency generally only capture inpatient SSIs, whereas significant primary care costs are associated with the treatment of SSIs. Patients with SSIs have long unplanned hospital stays (1-3); are five-times more likely to be readmitted after discharge, are 60% more likely to spend time in an intensive care unit, and twice as likely to die as those without SSIs (4). Healthcare-related costs almost double if a patient suffers an SSI. (5)
In our opinion the evidence suggests that not only will better surveillance and clearer reporting and transparency save lives and suffering, but it will mean a more efficient and cost effective NHS if the reporting helps to drive these infection numbers down. We are in no doubt that there is a commitment to a zero tolerance to avoidable infections, but for the Minister to remain credible, statements that Trusts are MRSA free should be avoided, as this simply is not true.
Health Protection Agency weekly figures over the last 12 months show that the difference between the best and the worst is 20 times, just for MRSA, and it is time that both the Government and the Department of Health targeted these underperforming hospitals more vigorously. For Clostridium difficile the difference can be as much as 182 times from the best to the worst, which clearly shows that with this bacterium there is even more work to do.
The Health Minister should remember that whilst he and his colleagues quite rightly praise the NHS staff for bringing down infection rates from an all time high in 2003/4, as a charity we are still inundated with calls for help from families, loved ones and patients, who still suffer the indignity of contracting avoidable healthcare infections from what Ministers state is a “world class service.”
MRSA Action UK
1. Plowman R, Graves N, Griffin M et al. The Socio-Economic Burden of Hospital Acquired Infection. London. Public Health Laboratory Service 2000.
2. Leaper DJ, van Goor H, Reilly J et al. Surgical site infection - a European perspective of incidence and economic burden. Int Wound J 2004; 1: 247–735.
3. Coello R, Charlett A, Wilson J et al. Adverse impact of surgical site infections in English hospitals. J Hosp Infect 2005; 60: 93–103.
4. Kirkland KB, Briggs JP, Trivette SL et al. The impact of surgical-site infections in the 1990s: attributable mortality, excess length of hospitalization, and extra costs. Infect Control Hosp Epidemiol 1999; 20: 725–30.
5. Broex EC, van Asselt AD, Bruggeman CA et al. Surgical site infections: how high are the costs? J Hosp Infect 2009; 72: 193–201.
6. New Year ambitions to reduce healthcare associated infections, Department of Health, January 13, 2012