MRSA Action UK: response to Gordon Brown's manifesto
Wednesday, 14 April 2010 12:00 AM
MRSA Action UK welcomes the commitments and pledges given by Gordon Brown in his manifesto and have made observations that we hope any new Government and Shadow Ministers will note.
Gordon Brown Pledge, "We will ensure all hospitals are clean and safe for both patients and staff"
Investment in the infrastructure of hospitals to ensure environments are easily cleaned is needed.
Actions as set out in the Health and Social Care Act 2008, must be properly regulated by the CQC with firm power to act if breaches in hygiene standards are found. This includes, and is not exclusive to, decontamination of equipment.
We need to look beyond the hospital setting and consider our surgeries and care homes, this will be a challenge as it is an ambition of this government to provide more care outside of the hospital setting, and infection rates are rising in the community setting, particularly when you look at Clostridium difficile. The Health Secretary's constituency sits in the region with the highest rates of Clostridium difficile - time for a change.
Training and guidance for staff at all levels on infection prevention and control must be mandatory and time and resources set aside to ensure all staff are equipped with the knowledge and skills to keep patients safe at all times when they are in their care. Recent media articles and research by the Royal College of Nursing suggest this is not happening in some NHS Trusts and this must be addressed.
Gordon Brown Pledge, "More than 3,000 matrons across the NHS will have the power to manage wards, order deep cleaning, and report problems directly to hospital boards"
Matrons already have the power to manage wards and report directly to hospital boards, strong leadership is required by Boards, if issues and concerns are raised then Chief Executives and Non-Executive Directors need to be held to account.
Infection prevention is everyone's business; if this is top of everyone's agenda then this will feed down through the organisation. Reporting to boards is one thing, taking firm action immediately is needed by everyone, don't just report it, clean it up.
If gross failings are found then the people in charge should be removed and where deaths are caused as a direct consequence of systematic failure to observe standards set out in the Health and Social Care Act 2008, they should be prosecuted.
Gordon Brown Pledge, "Every patient who comes into an NHS hospital will be screened for MRSA"
Screening is important, it's also important to ensure that once patients are screened effective measures are taken to make their surgery safer. If a patient is found to be MRSA positive, there should be sufficient isolation facilities and well-trained staff to look after them.
Staff must be confident to speak to the patient and relatives about MRSA, we are finding people are still not given sufficient information and approach our charity on a regular basis with worries and concerns because staff remain guarded about discussing the treatment of MRSA openly.
There needs to be better guidance and support for people who need to follow a decolonisation regime prior to surgery. If we are unwell then the decolonisation process can be exhausting and is often better carried out in hospital, too many vulnerable people are being expected to do this at home and if they are too unwell to cope and do this properly the process could prove ineffective.
Gordon Brown Pledge "We will establish national standards of infection control that get tougher every year and which every hospital and ward must meet"
Whilst the target introduced by John Reid in November 2004 was welcomed and great strides have been made to achieve it. We believe there has been too much of a focus on MRSA bacteraemias, we know that there are many more MRSA infections that go unreported, this includes urinary and catheter infections, surgical site infections and infections in IV lines and cannulae. MRSA accounts for around just 6.8% of all infections and is the tip of the iceberg. Other emerging pathogens should also be monitored and controlled, as recommended by the National Audit Office last year.
As a Charity we would like to see hospitals make available their rates of all hospital acquired infections. We would like to see these infection rates broken down to departments within hospitals, ideally by individual ward, and not just for the Trust overall which is of little use to patients using those facilities.
Gordon Brown Pledge, "The safety regulator will have the power to close wards, impose fines or order cleaning wherever necessary"
The regulator should not stop at imposing fines or ordering cleaning, action must go much further. If there are any breaches in any of the requirements of the Health and Social Care Act 2008, and the Code of Practice for the NHS on the prevention and control of healthcare associated infections, then action should ensue. For example, Section 8b - "Clinical procedures should be carried out in a manner that maintains and promotes the principles of asepsis" - The U-turn and stance taken on bare-below-the elbows is a specific concern for patients. It would be difficult to maintain asepsis if bangles were allowed to come into contact with a patient during clinical care, or sleeves or other jewellery, yet this has been highlighted as being relaxed only in the last week. Any NHS Trust that employs this practice and has higher infection rates than their peers would need to be questioned on the techniques employed, and challenged, indeed the Department of Health itself may be subject to challenge over such inappropriate guidance.
We would like to remind Gordon Brown that the pledges in his manifesto in relation to safety and cleanliness and healthcare have already been partially implemented and enacted in legislation. There is nothing new in these pledges. What needs to be new is that they are implemented in full and that patient safety should not only be the primary goal, but should override all other considerations.
ENDS
Derek Butler
Chair
MRSA Action UK
07762 741114
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