Dont catch a "Hospital"

Thursday September 14, 2006
An Audit Commission report in 2000 estimated that there were around 300,000 hospital victims of healthcare associated infections every year. However, recently released reports from the Health Protection Agency indicate that those figures may have been a vast underestimation.
In the last year alone, there were at least 69,000 cases of Clostridium Difficile (taking all age groups into account) and 47,000 cases of MRSA (assuming bloodstream cases account for 15% of the total). Given the proliferation of other healthcare associated infections, it would not be unreasonable to put the overall infection rate at around 500,000 a year.
Admission to hospital is a traumatic experience and the knowledge that Healthcare Associated Infections are prevalent in hospitals only adds to the anxiety. A survey has suggested that 25% of the population know of relatives or friends who have suffered such infections. This seriously undermines confidence in hospital safety, and reports of unacceptable levels of hospital cleanliness serve to reinforce such concerns.
There have been numerous government initiatives relating to hospital infections since 1990, but none of these has slowed the rapid increase in infection rates, and microorganisms are developing ever-greater resistance to existing antibiotics. Clostridium Difficile increased by 17% in the last year alone.
The financial cost to the NHS also continues to grow. It is estimated that infections cost at least ₤2bn a year and that a third of this figure could be saved if appropriate hygiene protocols were implemented in every NHS Trust.
Despite the human suffering and financial cost incurred, some NHS Trusts remain in denial of the problems that exist. Information relating to infection is withheld from patients, relatives only discover the presence of an infection from searching through their loved ones' medical records, and GP's are not routinely informed of infections when patients are discharged from hospitals.
In some instances, patients' records are not made available to other hospital departments and treatment commences without the patient's full medical history being known, placing the patient at further risk. The secrecy employed by some NHS acute trusts, and the blame culture that pervades the entire NHS, not only obstructs government initiatives, but puts patient safety at great risk.
It is also often suggested that infections are imported into hospitals from care and nursing homes, and by hospital visitors. A survey by Doncaster & Bassetlaw NHS foundation trust of elderly patients revealed that of 128 patients screened prior to admission only three were identified as being colonised with MRSA.
Tragically, another report from the Health Protection Agency identifies that MRSA in children under the age of 16 is increasing rapidly. Claims have been made that 40% of the population is colonised, yet no routine screening of hospital staff is undertaken on a regular basis.
No one can deny that the government has given additional funding to the NHS, however unless it is properly targeted there will be little improvement in service provision. The Healthcare Commission report on Stoke Mandeville hospital demonstrates what can happen when financial considerations are placed before patient safety. At Stoke Mandeville, 65 people lost their lives and 65 families were bereaved. Nationally, at least 50,000 people die from healthcare associated infections annually.
MRSA Action UK welcomes the government's latest initiative to introduce a mandatory hygiene code of practice, but we would also like to see the adoption of:
· Adequate additional funding to ensure enforcement of the code
· Extension of the code to all healthcare settings and providers, including the independent sector
· Development and implementation of a healthcare associated infection education programme by all NHS trusts, including primary care
· Training of all cleaning staff in infection prevention and control measures and accreditation
· Introduction of periodic environmental testing for hospital cleanliness, with results monitored and additional cleaning instituted where results fall below required levels
· More public/patient involvement in hospital inspections
· Adoption of antibiotic prescribing policies with appropriate enforcement
· Chief executives of NHS trusts to be held accountable for negligent and/or willful failure to ensure the application of the hygiene code of practice.
Graham Tanner is chairman of MRSA Action UK, a registered charity providing support to victims and people bereaved as a result of healthcare associated infections. As a mark of respect for the victims of Healthcare Associated Infections members of MRSA Action UK will lay floral tributes at the Innocent Victims memorial at Westminster Abbey on 14 September 2006.