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Email: derek.j.butler@mrsaactionuk.net

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Telegraph article
A GP's verdict on Alan Johnson's health plans

By Professor Hugh Pennington

Last Updated: 2:39am BST 26/09/2007

Alan Johnson told the Labour Party conference that matrons would be empowered to “fight infection on the front line”, that the “war” against Clostridium difficile must be intensified, and that a new regulator - Ofcare - will be given powers to fine dirty hospitals and close wards. He told GMTV that he wanted to see MRSA eradicated from wards - with a target of reducing its incidence to zero.

Great stuff! But will matrons be able to deliver? Are spotless wards the answer? Can MRSA be eradicated?

My answer to these questions are no, no, and no.

Controlling hospital-acquired infections is a complicated business. Matrons have very important roles as leaders and drivers of cultural change - surveys show that hospital staff are very poor handwashers, for example, and their role in improving this dismal statistic could be vital.

But what about microbiologists? They need empowering as well. We have always been fighting on the front line - but have usually been regarded by hospital managers as boffins in the background whose budgets can be raided for front line clinical services.

Matrons regard us as deliverers of bad news that comes in technical language that their training has poorly equipped them to understand. Team work, not just dragons stalking the wards, is the way forward.

It is reasonable to suppose that a dirty hospital is poorly run. If its public spaces are unclean, what is it like behind the scenes? But the converse is not necessarily true.

Clostridium difficile does not grow in dust. In hospitals it is spread by diarrhoea from its victims getting into or onto places that it should not - like the hands of nurses - and then from them into the mouths of susceptible patients.

Old-fashioned barrier nursing is the answer. Cleaning is easily to inspect, evaluate and score as a performance indicator. It would be a great pity if meeting Ofcare targets for it drew attention away from handwashing, which is much more difficult to measure but which is much more important in preventing infection.

Eradicating MRSA soon - if ever - is a pipe dream. It is so well-established in Britain that optimistic models for its control which start with the assumption that all the necessary preventative steps are in place and are working perfectly predict that bringing its level down to an acceptable one would take at least six years.

But none of the preventative steps are fully in place, and none are working perfectly. They are nowhere near as good as the Draconian “search and destroy “ measures that have been in operation in Norway and the Netherlands for years - and they still have MRSA from time to time.

Even if we saw off the two main villains of the piece, EMRSA 15 and 16 (E stands for ‘epidemic’), their parent, MSSA, is still going to be there. Thirty per cent of us carry it in our noses. It also causes infections after surgery. And it is very good at evolving in response to antibiotics.

I have nothing against matrons, or cleanliness, or stiff targets for MRSA. My prescription for progress is different, however. It is for a crash programme installing isolation facilities and much more money for microbiology.

The good news is that Gordon Brown favours the first. I hope he comes on board with the second.

Prof Pennington, emeritus professor of microbiology at the University of Aberdeen and the president of MRSA Action UK, is one of Britain’s leading experts on public health and hygiene


YOGHURT TO FIGHT C DIFF
10:00 - 25 September 2007
Live yoghurt drinks could soon be served in Notts hospitals to ward off deadly infections.

Health bosses plan to give the drink, which contains ‘friendly’ bacteria, to all elderly patients who are on antibiotics.

It is hoped a daily dose of probiotics will prevent cases of clostridium difficile, which causes diarrhoea. It could save the NHS thousands of pounds a patient.

The move was announced in the latest “superbug” report from Nottingham City Primary Care Trust.
The report also revealed two people from the city died from C Diff between April and June. Latest figures from the entire county are not available, but on average around 100 hospital patients in Notts develop C Diff each month. Health bosses say both Nottingham’s hospitals and Sherwood Forest Hospitals NHS Trust were implementing the use of probiotics.

The report said health workers across Notts, including those at care homes and community hospitals, should consider the idea. The drinks cost about £3.50 for a two-week supply, while research suggests that treating one case of C Diff can cost on average £4,000.

Hospital infections campaigner Moya Stevenson, of Sutton-in-Ashfield, said: “This is wonderful, but it should have been done years ago.

“Of course, cleaning still has to be a priority. Everything needs to be done together to make sure infections are kept under control.”

A spokesman said: “Nottingham City Primary Care Trust, along with all our partners in the local health community, is making strenuous efforts to further improve infection control, both in community and hospital settings.

“The PCT has a dedicated infection control team which receives a daily alert list identifying patients who have C difficile, including the elderly in care homes or their own home.

“The team then contacts the care home or the patient’s GP to make sure that the patient is receiving the correct treatment to manage the infection.”


Telegraph article
MRSA to force ban on doctors’ white coats

By Nicole Martin
Last Updated: 2:31am BST 18/09/2007

Doctors will be banned from wearing their traditional white coats as part of a drive to protect patients from contracting superbugs in hospital, Alan Johnson, the Health Secretary, has said.

Staff will also be ordered to ditch their ties, wrist watches and jewellery amid fears that they prevent doctors and nurses from washing their hands properly. The new “bare below the elbows” dress code, which hospitals in England will have to enforce by next January, is one of a series of measures announced by Mr Johnson to cut the rate of hospital-acquired infections such as MRSA.

They come only weeks after a report found that British hospitals were among the worst in Europe for superbugs, trailing behind countries including Slovakia, Hungary, Poland and the Czech Republic.

The Health Secretary also announced that matrons will be given new powers to help the Government to meet the target it set three years ago of cutting MRSA rates by half by next year.

They will report directly to their hospital boards four times a year to ensure that their views are heard by senior management.

The measures follow a warning from doctors last month that the Government would not meet its MRSA target because of poor hospital management practices.

An editorial in The Lancet in August blamed hospital managers for failing to train staff in antibacterial prescribing, and providing inadequate hand-washing and isolation facilities.

Figures from the Health Protection Agency (HPA) show rates of the superbug are falling - down 17 per cent since April 2004. There were 6,378 cases reported between April 2006 and March 2007.

Mr Johnson says he is determined to ensure that patient safety is a priority in the NHS.

“Across the NHS we continue to bring the number of MRSA cases down and make progress on measures to reduce C. difficile,” he said.

“Today’s package will give more responsibility to matrons and set guidelines on clothing that will help ensure thorough hand washing and prevent the spread of infections. This is a clear signal to patients that doctors, nurses and other clinical staff are taking their safety seriously.”

Patient groups welcomed the initiatives but said they were concerned that they would not improve hygiene conditions in hospitals sufficiently.

“At the moment, about 60 per cent of doctors don’t wash their hands between patients,” said Derek Butler, the chairman of MRSA Action UK.

“We applaud Mr Johnson for his commitment to cutting infection rates but we think the biggest challenge is getting hospital staff to improve their standards of hygiene. If the Government can’t do that, they are going to struggle to cut MRSA rates.”

Hospitals will also be issued with new guidance about isolating patients who become infected with C. difficile or MRSA.

This will mean more single rooms being used and more “cohort nursing” - where patients suffering from the same infection are nursed together.

In addition, hospital chief executives will have to report all MRSA and C. difficile infections to the HPA, or face a fine.

Dame Karlene Davis, the general secretary of the Royal College of Midwives, welcomed the Government’s commitment to cutting infection rates.

“One of the biggest killers of child-bearing women was puerperal sepsis. This has improved significantly with the recognition of the need for hand hygiene to reduce cross-infection,” she said.

“This situation remains as relevant today as it did many decades ago and the RCM wholly supports any measure which seeks to avoid infection.”


Four babies hit by superbug at hospital
RAYMOND HAINEY

7th September 2007

FOUR newborn babies contracted a potentially killer superbug on a Scottish maternity ward, triggering a major health investigation. The four babies were found to be suffering from Methicillin-Sensitive Staphylococcus Aureus (MSSA) after being born at Forth Park Hospital in Kirkcaldy within 13 days of each other.

Now an infection control team has been set up by the health board to examine how the bug was spread. NHS Fife has written to GPs and medical professionals warning them to be on the alert. The bug causes skin blisters and weeping from the umbilical chord and can be fatal.

Three of the babies, who are all under three weeks old, have been discharged from hospital after treatment with antibiotics; the fourth remains in hospital, although doctors described the child’s condition as “improving.”

Scotland’s leading microbiologist, Professor Hugh Pennington, said: “This is potentially very serious - any infection in children of this age has to be taken very seriously because they are much more vulnerable.”

He said that the hospital would work hard to get to the bottom of the issue. Prof Pennington added that MSSA was not as serious as another superbug, MRSA, because it responded better to antibiotics. But he added: “It’s not something you would want anyone to have, particularly a newborn baby.”

Prof Pennington said that maternity units were generally the most infection-free departments in any general hospital. But he also predicted it would be difficult to track down the source of the latest infection. He said: “Some of the mothers might carry it or the staff, although it’s more likely to be the mothers.

“Most people who have these types of bug don’t know they have them and they don’t do any harm”

He added that MSSA, in common with similar bugs, was highly mobile. Prof Pennington also pointed out: “There’s a hygiene aspect to this which is really the standard nursing approach. People should be washing their hands and using alcohol wipes. I’m sure that they will be looking at that to see if there was any problem.”

A spokeswoman for Fife NHS said yesterday: “No cause of the infection has been identified, however, investigations are ongoing.” She also said that while MSSA can spread easily it is usually a relatively minor infection.

Last updated: 07-Sep-07 00:43 BST

http://news.scotsman.com/health.cfm?id=1436122007

MRSA Action UK member
Dale honoured for courage after fending off Taleban ambush

Nantwich Chronicle
Wednesday, September 5, 2007

A MARINE from Nantwich has been given a bravery award for his valour while under attack by enemy forces in Afghanistan.

Lance Corporal Dale Law, of 42 Commando, has been honoured with a Three-Star General Commendation for his courage in fending off a surprise attack from Taleban fighters.


Dale, 24, said: “It was a bit of a shock to receive the award to be honest. I was told I was required to see the commanding officer so I thought I was in some sort of trouble. “But when I realised what it was about I was chuffed to bits. It is one of the highest awards you can get and something to be very proud of.”

Dale and a group of marines were sent out to an observation post close to a Taleban headquarters. After a quiet day, they were ambushed during darkness when insurgents tried to force their way through gates. He explained: “They were only 10 feet away from me, trying to get in but we managed to take them out and escape. I believe it was some of the closest contact with enemy troops since the Second World War. It was scary to see them taking the fight to us like that but the team’s skills meant we averted the situation.”

It was the first time Dale had been in a war zone after serving in the military for the past six years. As a Lance Corporal, he is second in command of his section. Originally from Liverpool, he moved to Winsford and studied at Verdin High School before settling in Nantwich with his girlfriend Kerry, who is expecting their first baby. His grandfather Ken Lawrence of Audlem, said: “I think it is only right he is recognised for his bravery and the family is very proud of him.”


Clinical Services Journal
Intensive care examined

The British Association of Critical Care Nurses recently held the 22nd National BACCN conference and exhibition at the Brighton Dome, bringing together over 300 professionals from the field of critical care. LOUISE FRAMPTON provides an overview of some of the highlights.

The BACCN event provided a forum for those working in intensive care units (ICUs) to share their insights into the latest techniques and best practice; to review current guidance and facilitate debate about professional, ethical and clinical issues in critical care management. The conference covered topics as diverse as: surviving Sepsis, the female experience of myocardial infarction and heart transplantation for a Jehovah’s Witness.

Infection control in ICUs was particularly high on the agenda. The challenges being faced by critical care units have been particularly well illustrated by the recent outbreak of pseudomonas aeruginosa at the Paediatric Intensive Care Unit at the Royal Hospital for Sick Children, in Glasgow, and by the closure of the ICU at Derby City Hospital - due to the discovery of VRE. MRSA received particular attention at the conference, however, with speakers highlighting the fact that ICUs typically emerge with the highest incidence of MRSA compared to other wards.

MRSA

Derek Butler, Chair of the MRSA Action UK charity, who lost his step-father to the infection, brought home the human cost of failure to prevent infection, commenting: “To accept what some think is inevitable in our hospitals would be a betrayal.”

Dr Ronan McCullan, a full-time NHS consultant medical microbiologist at the Royal Hospitals in Belfast, spoke about measures to prevent and control MRSA in critical care. He pointed out that infections lead to longer ICU stays and total hospital stay is prolonged by an average of 11 days. Furthermore, data suggests that ICUs may have a critical role in the dissemination of MRSA to other units within an institution. According to Dr McCullan effective measures include: active screening on admission, regular surveillance cultures and pre-emptive use of enhanced contact precautions. The effectiveness of isolating patients in single rooms, although common practice, has not been consistently demonstrated when evaluated in the ICU environment, he pointed out.

Similarly, while hand hygiene is effective, compliance among healthcare workers is adversely affected by increasing workload. He said that the ideal prevention and control strategy remains undefined, but suggested that a multifactorial approach will be required. This is likely to depend on technological advances, better understanding of healthcare worker’s behaviour and motivation and well conducted clinical trials of intervention programmes.

Elaine Coghill, Newcastle Upon Tyne Hospitals NHS Foundation Trust also highlighted the need to raise infection control standards in critical care to reduce the 17% of MRSA bacteraemias that are identified in patients in critical care (DoH 2006.) She described how the Trust has developed an e-learning tool to support traditional infection control training. Catherine Plowright, a consultant nurse, gave a poster presentation on the problems Medway NHS Trust experienced with MRSA bacteraemia. She outlined how the critical care unit at Medway Maritime Hospital successfully introduced an action plan to solve the issue. In November 2006, the Trust’s ICU was identified as having an unacceptably high MRSA bacteraemia levels compared to other hospitals in the strategic health authority. It was found to have eight bacteraemias in a five-month period - a significant deviation from previous incidences.

An “outbreak” meeting took place and an action plan formulated to review all of the Trust’s infection control procedures and to increase vigilance. The MRSA critical care pathway was developed and a screening policy implemented. The position of MRSA patients on the unit was also reviewed. Isolation precautions were reinforced in all bed areas and hand hygiene practices reviewed. Intervention was carried out on every patient with a central line, every day.

The Department of Health was invited to the Trust to review practices in critical care, while senior nurses visited a comparable unit with a low incidence of MRSA bacteraemia to benchmark best practice. The unit was closed for a major clean of ventilation systems and maintenance was increased. Every patient is washed every day with AquaSept irrespective of their MRSA status and cream applied to prevent soreness. Silver impregnated CVCs were used and doctors were instructed to wear scrubs. PC keyboards were replaced with ones that can be cleaned, while 2% chlorhexadine solution is used for infection control.

The data for 2007 shows a significant improvement, although the Trusts cannot be sure which interventions worked. It has had just one MRSA bacteraemia which was described as “unavoidable” since April 2007 on the ITU.

http://www.clinicalservicesjournal.com/Print.aspx?Story=3052



It’s not fun to play with MRSA

By Paul Jump,
Third Sector Online, 16 August 2007
A charity that campaigns for better hospital hygiene has reacted angrily to footage posted on video-sharing website YouTube featuring staff from a Scottish hospital singing a “crude and insensitive” song about MRSA to the tune of Village People’s YMCA.

The film, recorded at a Christmas pantomime at the Lorne and Islands District General Hospital in Oban, features staff in fancy dress singing: “It’s fun to clean up the M-R-S-A.”

Derek Butler, chairman of MRSA Action UK, said he had been alerted to the video’s existence by one of his trustees. “We couldn’t believe what we were seeing,” he said. “It was very crude and insensitive and made light of MRSA. That hospital has the third-highest rate of infections in Scotland and it was inappropriate when people there are suffering from MRSA.”

He said his phone had been very busy with calls from upset members of the charity. “One lady, who had lost her 32-year-old son to MRSA, was in tears all weekend,” he said. “It really hit home for her. We’ve had emails from people saying “people die - get over it”, but when you’ve watched someone die from an avoidable infection, it leaves its mark forever.”

A spokeswoman for the hospital said the pantomime had been intended to raise funds for charity and boost staff morale. “The staff were just using humour to highlight something they have been talking about a lot recently,” she said. “Nobody is saying MRSA is not serious. Staff are very dedicated and take their work, including reducing infections, very seriously. They regret any offence caused.”

She welcomed the fact that the video had now been removed from YouTube, although she said the hospital had no idea who was responsible for posting it.

Butler said: “If it had been educational, we would have applauded it. But it wasn’t. I told the hospital they should have put as much effort into reducing infections as they had into putting on this panto.”


THE SUN, Wednesday, August 15, 2007

A HEALTH board has been forced to apologise after workers sang a song about MRSA - to the tune of camp classic YMCA.

Six costumed staff at Lorn and Islands DistrictGeneral Hospital in Oban, Argyll, are heard singing the chorus “It’s fun to clean up the MRSA!” in a pantomime video.

The recording - a spoof of the hit by Village People, right - was posted on YouTube and also include lines about washing your hands after doing a “number one or number two”.

The video has left NHS Highland bosses red-faced because the hospital was recently found to have the third-highest rate of healthcare associated infections in Scotland.

Last night one victim of MRSA fumed “It’s utterly disgraceful.

“You cannot make a pantomime out of a serious disease.”

But campaigners last night failed to see the funny side.

Derek Butler, chairman of MRSA Action UK said: “I understand it was a Christmas panto, but I think a subject like MRSA is a bit too delicate for that.

“One of our members said, “What will it be next year - cancer or disabled children?” MRSA is a subject that should really be a no-no with these sorts of things.”

Professor Hugh Pennington, president of MRSA Action UK, added “There is always going to be black humour in medicine.

“It is all very well to do these things at Christmas parties in private, but when there is a possibility it could make it onto the internet, people need to be careful.

“This is a serious infection and should be more careful about how they approach it - especially when research suggests hospital staff are not always complying with the rules on washing their hands.”

Last night, David Whiteoak, a locality manager at NHS Highland, apologised.”

He said: “Our staff are very dedicated and take their work, including the control of infection, very seriously.

“The footage was taken at a staff fundraiser and I deeply regret any offence it has caused.”
gordontait@the-sun.co.uk


MEDICS’ FUN ROUTINE BUGS MRSA CHARITY
08:50 - 15 August 2007

Staff at a Highland hospital have apologised to a charity after claims that their song-and-dance routine “took the mickey” out of the killer superbug MRSA.

Staff at the Lorn and the Islands District Hospital at Oban performed the song about the disease to the tune of the Village People’s YMCA during a fundraising event.

But they were forced into an apology after the routine was captured on video and then put on the YouTube video-sharing website.

In a statement yesterday, David Whiteoak, the hospital’s locality manager, said: “Our staff are very dedicated and take their work, including the control of infection, very seriously. The footage was taken at a staff fundraiser and I deeply regret any offence it has caused.”

The Oban hospital was recently found to have the third-highest rate of healthcare-associated infections in Scotland.

Mr Whiteoak has also sent a letter of apology to the charity MRSA Action UK.

Pantomime video on the internet lands MRSA-spoof staff in trouble
LYNDSAY MOSS HEALTH CORRESPONDENT

Tue 14 Aug 2007

WORKERS at a Scottish hospital who performed a pantomime song about MRSA to the tune of the Village People’s YMCA were condemned as “utterly disgraceful” after footage of the episode appeared on the video-sharing website YouTube.

Costumed staff at Lorn and Islands District General Hospital in Oban were filmed singing the parody, which includes lines about washing hands after going to the toilet and using alcohol gels to ward off the superbug. It featured the chorus line: “It’s fun to clean up the M-R-S-A”.

The hospital was recently found to have the third highest rate of healthcare-associated infections in Scotland.

Campaigners were particularly angered by one line claiming patients were bringing the infection into the hospital. The charity MRSA Action UK pointed out that patients had caught it in healthcare settings in the first place. Derek Butler, its chairman, said:

“To put it bluntly, it is taking the mickey out of MRSA. I understand it was a Christmas panto, but I think a subject like MRSA is a bit too delicate for that.

“One of our members said, ‘what will it be next year - cancer or disabled children?’ MRSA is a subject that should really be a no-no with these sort of things.”

A patient who has suffered MRSA said the video was “utterly disgraceful” and added: “You cannot make a pantomime out of a serious disease.”

Professor Hugh Pennington, Scotland’s leading microbiologist and the president of MRSA Action UK, also questioned the appropriateness of the panto’s subject matter.

“There is always going to be black humour in medicine.

“It is all very well to do these things at Christmas parties in private, but when there is the possibility it could make it on to the internet, people need to be careful and you can understand why people become upset.

“This is a serious infection and people should be a bit more careful about how they approach it, especially when research suggests that hospital staff are not always complying with rules on washing their hands,” he said.

The charity has received a letter of apology from NHS Highland after raising the issue. David Whiteoak, locality manager at the board, said, even though the performance had been directed at hospital staff, “there are lines that should be drawn beyond which humour becomes poor taste”. He said any future show would be subject to a degree of censorship to stop any distasteful or offensive behaviour.

ALMOST one in ten patients in Scottish hospitals suffers from an MRSA-like bug.

A recent study found 9.5 per cent of people in acute hospitals had a healthcare associated infection.

The cost of such infections to the NHS north of the Border is estimated as at least £183 million a year.

The research, carried out by Health Protection Scotland, counted the number of patients with such infections in Scottish hospitals on one particular day.

Lorn and Islands Hospital, whose survey took place in winter, had the third highest rate, at 13.6 per cent of patients - behind Stobhill Hospital in Glasgow (18.3 per cent) and Falkirk Royal Infirmary (17.2 per cent).

A virus-based nasal cream that prevents the spread of MRSA could be available in two years, it was revealed yesterday.

This article: http://news.scotsman.com/scotland.cfm?id=1280212007
Last updated: 13-Aug-07 00:21 BST

(c) 2007 Scotsman


Our symbol of hope or the future

The Guardian August 8, 2007
Vivien Kandel, 01606 813617
A NINE-YEAR-OLD Cuddington schoolgirl has become the symbol of hope for an action group fighting against health infections which are prevalent in hospitals.
Hayleigh Proctor of Boundary Lane North is the mascot for MRSA Action UK.
The Cuddington Primary School girl was invited to London for a special ceremony last month to remember anyone who has died from health infections.
She laid a wreath with Tom Snowball an ex army medic, who is the oldest surviving member of the group.
Proud grandma Mavis Law from Winsford, whose son Colin died of MRSA four years ago, said: “All the other members of the group voted for Hayleigh to be the mascot. She is our hope for the future.”
Hayleigh said: “When I went to London it was very exciting. I’m glad I went for my uncle Colin.
“It was quite scary when I laid the wreath but it made me feel like a special person.”
She added: “I think if we get rid of MRSA now then it will help people in the future.”

Hayleigh Proctor who has been chosen as the mascot for MRSA Action UK.

This is Cheshire


IN MEMORY OF MRSA
8:04am Monday 6th August 2007

A WREATH laying ceremony has taken place at Westminster Abbey as a tribute to all those who have been lost and all those affected by healthcare infections.

The event took place at the Innocent Victims Memorial last Thursday and was attended by Professor Hugh Pennington, president of the MRSA Action UK and Claire Rayner who is now wheelchair-bound.

Mavis Law, from Winsford, who lost her son Colin to the disease, said it was a moving ceremony.

She said: “We had a lone Irish piper who played the bagpipes.

“The Conservative Party kindly sent a delegate as Stephen O’Brien was unable to attend this time and also the Lib-Dems kindly sent a delegate too.”
http://www.thisischeshire.co.uk/display.var.1591862.0.in_memory_of_mrsa.php


Moya Stevenson and Tom Snowball relate their experiences as two survivors of the hospital superbug live with the panel of experts. Friday 3rd August 2007


Superbug targets “will be missed”

3rd August 2007

By Jenny Hope
Medical Correspondent

MEASURES to halve the rate of MRSA infections in hospitals by next year will almost certainly fail, it has been claimed. Only vastly-improved staff management and snap inspections on wards will offer any chance of hitting the target, says The Lancet.

Hospital trusts should have to make infection control a top priority with a drive to encourage staff to wash their hands, says the medical journal. A six per cent drop in MRSA infections this year in England is too little too late, it declares. “The Government’s target to reduce MRSA rates by 50 percent by 2008 is unlikely to be met, says the article.

“adherence to hand-cleaning practices rarely exceeds 60 per cent among healthcare workers. But evidence shows that increasing the opportunities that health professionals have to clean their hands by placing an alcohol-based handrub beside every hospital bed and encouraging them to carry handrub, substantially improves hand hygiene practices.” Other practical problems that hamper staff efforts to prevent infections include the lack of single rooms in NHS hospitals to isolate and treat infected patients.

The Lancet supports the programme of snap hygiene inspections by the Healthcare Commission,England’s health watchdog. Last month the watchdog issued its first ever improvement notice on Barnet and ChaseFarm Hospitals in north London, demanding that the trust improves how it controls infections.

The target, set in November 2004 by the then Health Secretary John Reid, aimed to reduce hospital rates of MRSA bloodstream infections, which at the time stood at 21 infections a day. The rate is currently 15.86 infections a day - a cut of 28 percent since 2004 - but it will have to fall to 10.5 infections a day. Earlier this year a leaked memo from Liz Woodeson, the Director of Health Protection at the Department of Health, also claimed the target will be missed.

She said: “We are not on course to hit that target and there is some doubt about whether it is, in fact, achievable.”

MRSA Action UK chairman, Derek Butler, who lost his stepfather to the superbug three years ago, said: “We support the snap inspections that should bring it home to trusts that they’ve got make changes.” Norman Lamb, the Liberal Democrat Health spokesman, said the problem of superbugs like MRSA and the deadly stomach bug C.difficile in care homes was being neglected.

But the Department of Health insisted last night it would hit the 50 per cent target by March next year. A spokesman said: “Evidence from trusts that have made significant reductions shows that with the right focus and effort, including senior management commitment, this target should not be beyond any trust.”


MRSA
Thursday 26th July 2007 5:00pm

Despite the new figures from the Health Protection Agency showing rates of MRSA as dropping, around 60,000 people could be infected this year with the most widespread hospital superbug despite campaigns to tackle the problem.

In the first three months of this year 15,592 people over the age of 65 were infected with Clostridium difficile, a 2% rise on the same period last year. The bug takes hold in the guts of patients who have been given antibiotics and causes thousands of deaths. There were a total of 55,634 cases of C.Diff in 2006. Richard and Judy will be joined in the studio by Derek Butler, Chairman of MRSA Action UK and Tom Snowball, survivor of the hospital super bug.

Hospitals must be taken to the cleaners
Timesonline article

Discipline is the key to eradicating superbugs
Camilla Cavendish
In the week that Bournemouth council banned the issuing of armbands at its swimming pools, for fear of spreading germs, we are told that 60,000 hospital patients this year will catch the superbug Clostridium difficile. While one part of the public sector is infected with a virulent strain of health and safety disease (let’s call it HSD), another - the part that is supposed to look after our health - seems strangely immune.

No one has ever been knowingly infected by blowing up a rubber ring. But the head of the Institute of Sport and Recreation Management was unrepentant, stating: “I don’t think it’s health and safety gone mad to say that something should be clean and safe.” He is surely the perfect candidate to run one of the quarter of hospitals that are not meeting even the basic requirements of the hygiene code.

Even though there is not much hand-washing going on in the NHS, there is plenty of hand-wringing. Cases of “C diff”, as it is known in the trade, have risen by 22 per cent in the past year, affecting more than 15,500 people over 65. It is not always lethal: in 2005 it was mentioned on 3,697 English death certificates (MRSA was mentioned on 1,512). But those figures understate the problem, because hospital-acquired infections often go unmentioned as a factor in death. The campaign group MRSA Action UK believes that many deaths that are listed as organ failure will also have involved MRSA.

It is generally agreed that the UK’s performance in combating these bugs lags behind every other European country except - oh, here’s a comfort - Romania. The good news this week was that MRSA rates have started to fall, by 6 per cent in three months. But even this must be seen in the context of a sixfold increase over the past decade.

When superbugs first invaded hospitals in the Netherlands in the early 1990s, the Dutch took a zero-tolerance approach. They used an age-old tactic of infection control: isolating patients in dedicated wards. Their relatively clean hospitals were spruced up even further, and staff who came into contact with infected patients were tested. Mark Enright, an epidemiologist at Imperial College, London, says that NHS managers thought the Dutch had overreacted. But 15 years on, their MRSA rates are 50 times lower than ours.

It is trickier to isolate patients in the NHS because it has far fewer empty beds than almost any other Western health service. That is a direct consequence of the determined reduction in hospital beds from almost 300,000 20 years ago to 175,000 last year. At Stoke Mandeville, where at least 33 and possibly 65 people died from C. difficile in 2004, staff claimed that they could not isolate patients because of budgets and waiting-time targets.

This lack of beds and conflict between targets is critical for ministers to address. But it has been largely obscured by the focus on hand-washing. The problem is that, while hospitals remain dirty, it is hard to see the bigger issue. Ministers must also realise that all these “Wipe Out!”, “Saving Lives” and “cleanyourhands” initiatives, unusually self-explanatory for this acronym-laden bureaucracy, have been staggeringly ineffective.

It is quite clear that a package of measures is needed to combat these infections: it includes isolation of patients, much more careful use of antibiotics in the case of C. difficile, and proper hygiene. The Health Protection Agency this week produced figures showing that some hospital trusts are doing quite well. But they will not permit us humble patients to know the success or failure rates for individual hospitals. The discrepancies must be far too revealing.

The fact is that a clean hospital is a well-managed hospital. Infection control is not impossible. What it really boils down to, in the words of Georgina Duckworth, of the Health Protection Agency, is “running a tight ship”. Only a well-managed hospital will get a grip on superbugs. And the fact is that there are still far too many poorly managed hospitals. The superbugs are not only a problem in themselves - they are also a symptom of what is wrong with the NHS culture.

When voters said that they wanted to bring back matron, they did not mean “appoint someone with the title of matron and ask her to build partnerships with team members towards a better future”, which is pretty much what happened in 2001. They wanted someone with the authority and willingness to tell others what to do.

The Healthcare Commission report published this week contains some telling quotes from NHS employees. “It’s difficult to enforce authority like it was in the past,” says one. “Staff have so many rights, unions, human resources,” says another. And the report concludes that “overly authoritarian or hierarchical styles of management” can now be perceived as “bullying”.

On recent visits to hospitals I have watched as staff turn a blind eye to nurses who do not wash their hands and cleaners who do not clean. Two weeks ago, a postoperative colleague complained about a huge splotch of blood on the wall of the toilet. “Oh,” said the nurse, “we hoped you wouldn’t notice.”

Talk to former members of the nursing profession, such as my great-aunt and my mother-in-law, and they will tell you how they quaked when the infection control man made his daily visit to the ward and ran his finger along the top of every bed curtain. They would not have made excuses about outsourced cleaning contracts. They just got on with saving lives.

Outside the NHS, health and safety is being enforced maniacally. There is no shortage of bossy enforcers to remove your rubber ring. I never thought I’d say it, but we need a bit more of that in the NHS.

http://www.timesonline.co.uk/tol/comment/columnists/article2141315.ece


TRIBUTE TO THE INNOCENT VICTIMS WESTMINSTER ABBEY 19 JULY 2007


Health

A service outside Westminster Abbey last week to remember victims of MRSA. People here feel both sorrow and deep frustration that hospital infection rates remain so high. MRSA is falling in England but not fast enough to meet government targets and C difficile cases are still rising despite pledges to get tough on infections. BBC News Player - Hospital Infections Rising


Hospital superbug soars by 22 per cent in just three months

In the early 1990s, just over 1,000 patients a year fell victim to C.diff. Today, more than 1,000 are infected each week.

A bigger killer than the MRSA superbug, C.diff claimed 2,247 lives in 2005 - a 69 per cent rise on the previous year. The latest figures do not record the number of deaths.

The HPA, which also released figures showing a slight drop in MRSA cases, admitted “there is still a lot of work to be done”.

But experts in infection, patients” representatives and politicians said the Government was guilty of a “spectacular failure” to halt the rise of C.diff and described hospital hygiene as “sorely defective”. The criticism comes a week after England’s most senior doctor attacked hospitals for “unacceptably low levels” of hygiene.

Chief medical officer Sir Liam Donaldson said the failure of doctors and nurses to wash their hands was a key factor behind the superbug crisis.

A Healthcare Commission report released on 25th July 2007 blames pressure to meet treatment targets and cut waiting lists for lapses in infection control in many hospitals.

Liberal Democrat health spokesman Norman Lamb urged hospitals to clamp down on staff who break hygiene rules.

He said: “The Government’s strategy to deal with superbugs has spectacularly failed to halt the rise of Clostridium difficile, with deadly consequences.

“Hospital staff should treat failure to comply with hygiene standards as a very serious issue, akin to gross misconduct.

“Disciplinary action may be required to ensure that standards are met and lives are saved.”

Joyce Robins, of Patient Concern, said high bed occupancy rates left staff unable to clean wards thoroughly between admissions.

She added: “We have let this get completely out of control. People shouldn’t be dying of something they didn’t go into hospital for in the first place.”

Professor Hugh Pennington, a leading microbiologist and president of MRSA Action UK, described hospital hygiene as “sorely defective”.

He said that while cases of MRSA had fallen by 10 per cent, with 6,378 between April 2006 and March 2007, much remained to be done.

“The drop is quite a small one and the problem remains,” he said. “The target to be aiming for is a 90 per cent drop and we are not going to be there any time soon.”

Kate Jopling, of Help the Aged, said: “It is a relief that levels of MRSA are starting to decrease but it will be cold comfort to grieving families who have lost loved ones to avoidable hospital infections.”

Clostridium difficile exists naturally in the stomachs of many healthy adults, where it is kept under control by “friendly” bacteria. The problems start if the balance of bacteria is disturbed, perhaps as a result of taking antibiotics for another infection.

Once the “friendly” bacteria are killed off, the C.diff is able to multiply and produce the toxins which cause diarrhoea and, in the worst cases, a potentially fatal infection of the abdomen.

The spread of the bacterium, via hardy spores, is swift.

But it can be combated using simply soap and water, while powerful disinfectants can keep hospital floors bug-free.

The National Audit Office estimates there are 300,000 cases a year of hospital-acquired infections, including C.diff and MRSA, and at least 5,000 deaths.

Posted on Tuesday, July 31, 2007 at 10:50AM by
References (1)
References allow you to track sources for this article, as well as articles that were written in response to this article.
Source: Hospital superbug soars by 22 per cent in just three months
by FIONA MACRAE on July 26, 2007


Hospital superbug soars by 22 per cent in just three months
By FIONA MACRAE - Last updated at 08:44am on 25th July 2007

More than 1,000 patients are infected each week by the C.diff bug. Cases of a deadly hospital superbug which thrives in filthy conditions have soared to record levels.

In the past year, almost 56,000 vulnerable and elderly patients have caught Clostridium difficile - a stomach bug that can be halted with simple soap and water. Between January and March alone, 15,592 people were infected with the bug - a staggering 22 per cent rise on the previous three months. The true toll is likely to be even higher, as the figures cover only the over-65s who account for 80 per cent of infections. The figures from the Health Protection Agency highlight the failure of numerous Government drives to halt the rise of a bug which is spread by dirty hands and bedding.

In the early 1990s, just over 1,000 patients a year fell victim to C.diff. Today, more than 1,000 are infected each week. A bigger killer than the MRSA superbug, C.diff claimed 2,247 lives in 2005 - a 69 per cent rise on the previous year. The latest figures do not record the number of deaths.

The HPA, which also released figures showing a slight drop in MRSA cases, admitted “there is still a lot of work to be done”. But experts in infection, patients’ representatives and politicians said the Government was guilty of a “spectacular failure” to halt the rise of C.diff and described hospital hygiene as “sorely defective”. The criticism comes a week after England’s most senior doctor attacked hospitals for “unacceptably low levels” of hygiene.

Chief medical officer Sir Liam Donaldson said the failure of doctors and nurses to wash their hands was a key factor behind the superbug crisis.

A Healthcare Commission report to be released today blames pressure to meet treatment targets and cut waiting lists for lapses in infection control in many hospitals. Liberal Democrat health spokesman Norman Lamb urged hospitals to clamp down on staff who break hygiene rules. He said: “The Government’s strategy to deal with superbugs has spectacularly failed to halt the rise of Clostridium difficile, with deadly consequences. “Hospital staff should treat failure to comply with hygiene standards as a very serious issue, akin to gross misconduct. ”Disciplinary action may be required to ensure that standards are met and lives are saved.”

Joyce Robins, of Patient Concern, said high bed occupancy rates left staff unable to clean wards thoroughly between admissions. She added: “We have let this get completely out of control. People shouldn’t be dying of something they didn’t go into hospital for in the first place.”

Professor Hugh Pennington, a leading microbiologist and president of MRSA Action UK, described hospital hygiene as “sorely defective”. He said that while cases of MRSA had fallen by 10 per cent, with 6,378 between April 2006 and March 2007, much remained to be done. ”The drop is quite a small one and the problem remains,” he said. “The target to be aiming for is a 90 per cent drop and we are not going to be there any time soon.”

Kate Jopling, of Help the Aged, said: “It is a relief that levels of MRSA are starting to decrease but it will be cold comfort to grieving families who have lost loved ones to avoidable hospital infections.” Clostridium difficile exists naturally in the stomachs of many healthy adults, where it is kept under control by “friendly” bacteria. The problems start if the balance of bacteria is disturbed, perhaps as a result of taking antibiotics for another infection. Once the “friendly” bacteria are killed off, the C.diff is able to multiply and produce the toxins which cause diarrhoea and, in the worst cases, a potentially fatal infection of the abdomen. The spread of the bacterium, via hardy spores, is swift.

But it can be combated using simply soap and water, while powerful disinfectants can keep hospital floors bug-free. The National Audit Office estimates there are 300,000 cases a year of hospital-acquired infections, including C.diff and MRSA, and at least 5,000 deaths. This equates to a patient being infected every two minutes - and one dying every two hours.

The Health Protection Agency said the 22 per cent rise in Clostridium difficile figures at the start of this year echoed a similar increase at the start of 2006. It could be attributed to more frail and elderly people being admitted to hospital during the winter. Dr Christine McCartney, an HPA microbiologist, said: “There is still a lot of work to be done if we are to continue to achieve reductions in both MRSA and Clostridium difficile. “Many of these infections are preventable, if hygiene and antibiotic-prescribing guidelines are strictly followed by hospital trusts.”

Three weeks ago, the Government pledged to put an extra £50million in to improving infection control. Health Minister Ann Keen said: “The hard work of NHS staff has been vital in reducing MRSA infections. “We now need to redouble our efforts to tackle Clostridium difficile and continue this progress.” The MRSA figures show the biggest falls have been in London and acute teaching trusts. Click here for on-line article and readers comments


MRSA Action UK Press Statement
Response to Latest Figures on Healthcare Infections in England and Wales

24th July 2007

MRSA Action UK is dismayed that today we have seen that this year’s figures for Healthcare Associated Infections in our hospitals have not reduced as significantly as we had hoped. This Government gave a commitment in 2005 that it would reduce by half the rates of infections for MRSA in our hospitals by 2008.

We believe a true baseline is required to assess just how many thousands of people die and are suffering continuing infirmity from healthcare infections. The figures used are massively undercounted and reflect only around 6% of all healthcare infections - they are quite simply numbers of bloodstream bacterium reports, and do not account for the many infections in surgical wounds and infections contracted through urinary catheters, drips, and other clinical procedures. For Clostridium Difficile only cases for the over 65 age-group are mandatory for the measurement of how hospitals are improving.

It is clear that the target of reducing the smaller proportion of bloodstream bacterium reports is not achievable under the current regime. This Government owes the people of this country an explanation as to why. Despite these figures being vastly underestimated each number represents a person and where that person has died a loss to a family. Where that person has survived that number represents a massive cost in terms of suffering, and in many cases continuing disability, a drain on resources and a financial burden. This has led to a lack of public confidence in the healthcare system and a fear of going into hospital.

A politician once said “That a society can judge itself as being civilised by the way it treats its old, its sick and its dying” can our Government really say that while it has people suffering and dying in our hospitals from Healthcare Infections we can really call ourselves civilised. As a society it has to be wrong that so many people are suffering and being lost to these infections that are so easily avoidable. As a Charity we believe that to do nothing would be to discharge our responsibility to society, and to accept what some think is inevitable in our hospitals would be a betrayal.

Our New Prime Minister Mr Brown has publicly stated that his first priority in the NHS is to begin to reduce significantly the incidents of Healthcare Associated Infections. We applaud and support those words, but we believe that it is only by putting those words into action that we will see the pain, suffering and distress caused by these infections diminish.

We call on our Prime Minister and his Government, and for the opposition parties to meet with us so that he can help us to help him in his aim of reducing infections in our healthcare settings and to achieve what we all desire and that is a safe environment for us all to be treated in.

We can no longer have the situation were this subject is used as a political football to be bounced around to suit any body’s particular agenda. There has to be no more spin; there has to be no more inaction; and particularly there has to be no more trying to sell this subject with a public relations strategy in convincing us that they are winning this battle, as outlined in the recent reports that this Government believes it has to improve presentation. Our Charity calls on our elected representatives to collaboratively work together to significantly reduce these infections in our hospitals as our common aim. We believe as a Charity that “If there is a wrong, it is incumbent on those that have the ability to correct that wrong, to take responsibility to make it right”. Our Charity believes this is true, not just for our elected representatives, but also for those that work in our NHS. They amongst us all have the ability to make those changes happen if they have the courage to do so.

As a Charity we would like for those in authority to remove what we cannot see, this is not about keeping up appearances. It is the isolation and removal of the bacterium that will reduce the incidents of patients contracting avoidable healthcare infections.

We firmly believe that there has to be a change of ethos within the NHS as to the systems of work that are used. It will only be by moving infection prevention and control into the 21st Century that we will see the significant reductions that are required, a developed nation should be able to do this and provide the care that patients deserve. Our Charity believes that we need to ensure that the basics of infection prevention and control are securely in place and that there is total compliance with the necessary hygiene controls, those being strict hand hygiene and aseptic technique, environmental hygiene and design, availability of isolation facilities, screening of patients and of the NHS staff. There has to be complete adherence to the Hygiene Code. There can be no more excuses as to why 25% of our hospitals are not meeting the basics of the Hygiene Code and those that cannot meet that basic standard we believe should be issued with an improvement notice such as was issued to the Chase farm Trust this month.

It is clear that improvements are not happening quickly enough. In the search for ways to drive change, the Chief Medical Officer has cited recent initiatives focussing on empowering patients and their families to remind healthcare professionals about the importance of hand hygiene. Whilst there are some of us who are quite prepared to do this, many patients and relatives find this approach daunting. The unconscious patient cannot do this, the most vulnerable people may not be in a position to do this. It is the responsibility of the healthcare worker and the systems that are in place that should safeguard our most vulnerable people from acquiring preventable infections. We have given this feedback to the Department of Health and hope that this does not go unheeded.

MRSA Action UK believe patients must be informed that all NHS bodies have a general duty to protect patients, staff and others from healthcare infections, as prescribed in the Hygiene Code, and that all should be reminded that this is a statutory requirement to adhere to the Code

“Patients must always be provided with full and sufficient information to facilitate informed choice as to their healthcare

“The care and safety of patients must never be compromised under any circumstances

“ Patients have a role to speak up and to challenge unsafe practice, and the right to expect any challenge to be acted upon, but it is ultimately the responsibility of the healthcare provider to provide safe care

If medical science and techniques have moved into the 21st Century, then the way that the NHS staff interacts with these advances has to be brought into the 21st Century as well. The bed occupancy rates and the lack of isolation facilities at present do not make good infection control easy.

We at MRSA Action UK know that if we cannot attain the changes necessary to ensure that our hospitals are safe and clean then future generations will not forgive us for our inactivity on this issue.

At MRSA Action UK along with others, we believe that this situation can be changed, and that by working collaboratively together we can change things for the better. These latest figures show however that after years of promises from those in authority very little has been changed. It is time that all those concerned with healthcare acquired infections stopped the squabbling, the finger pointing and apportioning blame and collaboratively worked together to start to bring our infection rates down to those comparable with the Netherlands and our Northern European neighbours.

We have to say however that we find it ironic that this Government have put healthcare infections as a priority in respect to the NHS yet our Charity held a Memorial event on the 19th July to remember all those that have suffered or been lost to healthcare acquired infection. The event was just 7 days before these figures were released, and there was not a single representative at that event from the Labour contingent of the UK Parliament. Those MPs that did attend confirmed that this is of major concern to constituents. Our Tribute can be viewed at http://mrsaactionuk.net/Tribute2.html, media coverage of the event included the Press Association and the BBC.

We find the lack of concern shown at odds with the comments of our Prime Minister and his Government to the people of this Country. For a copy of the figures click here

Derek Butler
Chair, MRSA Action UK


Superbug screening plan for patients

HELEN PUTTICK, Health Correspondent
July 19 2007
The Scottish Executive is prepared to fund the screening of patients for superbugs before they receive hospital treatment. Health Secretary Nicola Sturgeon today promises she will introduce testing for MRSA, assuming experts back the approach as expected this autumn.

In what could prove to be a landmark announcement, Ms Sturgeon said if specialists give the go-ahead, she is “determined” to find the money to finance a screening programme. Her announcement comes a week after a groundbreaking study found almost one in 10 patients picks up an infection in Scotland’s major hospitals after they arrive.

It confirmed one of the biggest problems on the wards is MRSA, a drug-resistant bacterium carried on the skin that can prove fatal when it gets inside the body. An investigation of whether patients admitted to Scottish hospitals could be screened for the superbug is already under way and a final report is expected around September.

The consultation document recommends swab-testing all patients and isolating those carrying the bug in single rooms to stop the bacterium spreading. The proposal raises many questions about how hospitals would create and staff the isolation wards and the bill for implementing the strategy would run to tens of millions of pounds.

However, last week’s report calculated the cost of healthcare associated infections (HAIs) to Scotland’s major hospitals is £183m a year.

Writing in The Herald today, Ms Sturgeon says: “It will take time to make a real difference, but the report left me in no doubt about the need to step up our efforts. It is imperative that we continue to drive up cleaning standards in our hospitals. And, if the experts give the go-ahead, I am determined that we will fund an MRSA screening programme.”

Leading microbiologist Professor Hugh Pennington has long supported patient screening backed by the isolation of those with positive results. Last night, he said: “We have not really had any systematic approach to this problem in Scotland. It has been done piecemeal basically reacting to outbreaks, some hospitals being keener than others Having a universal screening policy could drive standards up in a positive way everywhere.”

The GoldenJubileeNational Hospital in Clydebank screens patients for MRSA on admission. It has not had a case of MRSA infection for the past two years.

Derek Butler, chairman of charity MRSA Action UK which is laying wreaths at Westminster Abbey today as part of its awareness campaign, said: “If Scotland is going down the screening route we applaud the Scottish government and the Scottish health system for doing what is the natural thing.”
http://www.theherald.co.uk/news/news/display.var.1555718.0.0.php

One in ten Scottish hospital patients ‘suffering infection’

19 July 2007
The new study carried out in Europe found 9.5 per cent of people in acute hospitals had a healthcare associated infection (HAI)
“It is no coincidence the lowest levels of HAI in the UK are found where there are the lowest levels of contracting out - in Wales.”

And the cost of such infections to the NHS is thought to be at least £183 million a year. Experts and campaigners last night said that HAIs continued to be a problem because of poor hygiene in hospitals and a lack of isolation facilities.

Professor Hugh Pennington, Scotland’s leading microbiologist, said more attention was also needed to ensure that only patients who needed antibiotics were receiving them to help tackle drug resistance. Nicola Sturgeon, the Scottish health secretary, yesterday pledged to step up efforts to combat HAIs in light of the latest figures, which give the most accurate picture yet of the issue. This includes the possibility of introducing an MRSA screening programme for those going into hospital.

The new report, by Health Protection Scotland, suggested the rate of HAIs is higher in Scotland than the rest of the UK. A study by the Hospital Infection Society from February to May 2006 found that 8.2 per cent of patients in England had an HAI, 6.3 per cent in Wales and 5.4 per cent in Northern Ireland. Over the same three-month period, the rate in Scotland was 9 per cent.

But experts said the differences in rates were most likely due to the more comprehensive nature of the Scottish survey, which covered every acute hospital and a sample of community hospitals. The HPS report involved teams going into every acute hospital - 45 in total - and a sample of 22 community hospitals between October 2005 and October 2006. There they counted the number of inpatients over the age of 16 with an HAI who were in hospital on the day of the visit. In total, they found 1,103 patients in acute hospitals had an HAI - amounting to 9.5 per cent of all these patients. Of these, 126 had more than one infection. In the sample of non-acute hospitals, they found 157 patients with an HAI, of which seven had more than one. Taken across the country as a whole, this could mean more than 1,800 patients in hospital have an infection at one time.

The report found that Clostridium difficile was the most common bug among infections where researchers had identified the organism, accounting for 17.6 per cent of cases. This was followed by MRSA (methicillin-resistant Staphylococcus aureus) at 17.2 per cent and MSSA (methicillin-sensitive Staphylococcus aureus) at 8.9 per cent. The hospital with the highest HAI rate in Scotland was Stobhill Hospital in Glasgow at 18.3 per cent, followed by Falkirk Royal Infirmary at 17.2 per cent. But the reason for the higher rates may be that these hospitals were surveyed during winter, when infections are more common.

Older hospitals have sometimes been blamed for rising rates of infection. But yesterday’s figures showed that this was not necessarily the case. The flagship Edinburgh Royal Infirmary, which opened in 2003, had an HAI rate of 11.6 per cent, compared with 6.8 per cent at the much older Southern General Hospital in Glasgow. Rates also depend on the type of patients treated, with older people more vulnerable. And hospitals also have to deal with patients and their visitors bringing infections in.

Dr Jacqui Reilly, from HPS, said HAIs clearly had an impact on costs to the NHS, adding:

“Patients with an HAI stay in hospital 70 per cent longer than those without an HAI.” And she said if infections were cut by 30 per cent, the NHS could save £55 million a year.

Ms Sturgeon said this money could pay for an extra 8,000 patients to be treated. She added:

“It is not good enough that 9.5 per cent of patients in Scottish acute hospitals have some form of HAI. The £183 million cost to the NHS, together with the human cost of HAI is also unacceptable.”

Prof Pennington said the key to tackling HAIs was to continue with measures already in place, but to do them better.

He added: “At the moment we are just about holding our own, but cases of MRSA are not going down and C difficile is going up. We need to continue to implement policies to control antibiotic prescribing, which contributes to resistance. “The cleaning and hand hygiene must also be a key focus. I am also in favour of screening, but it would need to consider what we do with patients who are carrying the bugs.”

Prof Pennington said Scotland and the UK in general did not have enough isolation facilities to care for patients with an infection, and added that there was evidence of more virulent strains of infections spreading.

Moya Stevenson, of campaign group MRSA Action UK, said it wanted to see screening for MRSA in hospitals.
She added: “Bed occupancy rates have to be reduced within our hospitals and this will reduce quite significantly those rates of infections.”

Willie Duffy, from health union Unison, said that the quality of cleaning in hospitals had declined since the introduction of competitive tendering of hospital cleaning in the 1980s and the continuing outsourcing of cleaning at PFI hospitals. He added: “It is no coincidence the lowest levels of HAI in the UK are found where there are the lowest levels of contracting out - in Wales.”

http://www.careandhealth.com/Pages/Story.aspx?EntityID=857326a6-0ca5-4439-b6c1-b66ac08e9f11


MEMORIAL FOR MRSA VICTIMS
11:00 - 17 July 2007

A Notts charity which battles against superbugs is holding a memorial service in London for victims’ families. MRSA Action UK is staging the event on July 19 from 12.45pm at the Innocent Victims Memorial, Westminster Abbey. It will be followed by a reception at the Strand Palace Hotel, The Strand, from 2pm. ”Our event is to remember those that have suffered and survived an avoidable healthcare infection, but also to remember those lost to what we believe was something you thought was never a threat to their lives,” said Moya Stevenson. She helped set up the group after contracting MRSA after a routine operation at King’s Mill Hospital, Sutton-in-Ashfield, in 2004.


NHS plan to tackle MRSA with spin
16th July 2007

Sometimes a news story about the NHS demonstrates such stupidity by its management that one despairs that they will ever get to grips with the fundamental issues that need addressing.

It seems that its managers have commissioned a study from the pollster Ipsos MORI, yes, spent money that should have gone to front line patient care, to find out how to change the public’s opinion of how the NHS is tackling MRSA! Not to do anything about MRSA you understand, just to change the way we think about it!

The advice, contained in a leaked report to the NHS chief executive, is to make cleaning more visible. The public will feel that hospitals are getting on top of MRSA if they see cleaners during busy times, and if they are visible, so they should wear distinctive uniforms.

Ben Page of Ipos MORI said “My job is to help people feel better about the NHS. “There is little correlation between actual MRSA infection rates and how people feel about their hospital. “It comes down to perception and the way they were treated by staff, about how well cared-for they felt the place was, rather than the actual reality.”

Professor Hugh Pennington, a microbiologist and the president of the patients’ charity MRSA Action UK, said: “I think this is a cynical approach. I can see that it might be reassuring to see a lady with a mop, but it doesn’t necessarily improve your chances. “I would rather they invested money in the sort of things that make a difference to infection rates, such as bringing in isolation facilities.”

This comes at a time when the hospitals failing to tackle superbug infections are being been served with official warnings for being in “serious breach” of the Hygiene Code.

This of course is not the only money that the NHS is spending with polsters. Another recent study was commissioned to discover that 96% of us think that the NHS is a key part of British society, and that 93% of us think that the NHS should pay more attention to customer services. Did they have to spend money to find out this! Would this money not have been better spent on patients!

http://www.careworld.net/blogs/index.php?blog=2&cat=29


Now Labour tries to spin out of MRSA crisis

By Laura Donnelly, Health Correspondent, Sunday Telegraph

Last Updated: 1:17am BST 15/07/2007

Hospitals will be told to make their cleaners more “visible” - and even wear special uniforms - in an attempt to persuade the public that the superbug crisis is under control, according to secret government plans.

A report commissioned by the Department of Health (DoH) recommends an increase in “the visibility of cleaning staff” so that hospitals are “seen” to be cleaner.

The spin tactics are contained in a presentation to the NHS chief executive by Ben Page, chairman of the pollster Ipsos MORI, which warns that dirty hospitals remain a major public concern. The document, leaked to The Sunday Telegraph, underlines that not only should hospitals be made cleaner, they should - more importantly - “be seen to do so by patients”.

It is understood cleaners may now have to wear distinctive uniforms, and work during the busiest times of the day, to make their presence more visible. The document follows a previous confidential DoH memo admitting the NHS will not hit its targets to cut the hospital superbug MRSA, and setting out public relations strategies to deal with the ensuing criticism. The fresh revelation sparked anger from experts in infection control who said the Government should not be focusing on spin when the number of deaths linked to the bugs MRSA and Clostridium difficile continues to rise - by 60 per cent between 2004 and 2005. Last month one in four hospitals was found to have failed to meet basic infection controls standards.

Professor Hugh Pennington, a microbiologist and the president of the patients’ charity MRSA Action UK, said: “I think this is a cynical approach. I can see that it might be reassuring to see a lady with a mop, but it doesn’t necessarily improve your chances.

“I would rather they invested money in the sort of things that make a difference to infection rates, such as bringing in isolation facilities.”

The shadow health secretary, Andrew Lansley, said he was not surprised the Government was resorting to spin. “Putting a high visibility jacket on a cleaner doesn’t change anything,” he said. “If anything, these tactics will undermine what confidence people have in the Government.” Mr Page admitted: “My job is to help people feel better about the NHS. There is little correlation between actual MRSA infection rates and how people feel about their hospital. It comes down to perception and the way they were treated by staff, about how well cared-for they felt the place was, rather than the actual reality.”

Katherine Murphy, of the Patients Association, said she was “disgusted” by the tactics. “This is just cheap spin,” she said. “If they need to solve the problem, they should stop cutting back on cleaning budgets, for a start.”

Derek Butler, who lost his stepfather to MRSA, said: “Gordon Brown said this would be the end of spin. But making hospitals look clean isn’t the same as making them clean. We want proof that wards are clean, and that means tests, swabs and inspections.”

A DoH spokesman said: “Cleanliness has always been an important issue and it is a factor that affects patient confidence. We recently announced an extra £50 million to tackle healthcare associated infections.”

Mr Page said: “The very act of cleaning happening around them makes people feel better about the cleanliness of a hospital. It is also about having branded, highly visible cleaners, wearing something that is distinctive.”


‘It was terrible to watch her deteriorate’
LYNDSAY MOSS HEALTH CORRESPONDENT
THE SCOTSMAN
Thu 12 Jul 2007

NELLIE McCafferty was a lively, happy 82-year-old who enjoyed going out with friends and spending time with her family. But after being diagnosed with MRSA, her health deteriorated and she died last year.

Her daughter, Linda McCafferty, said the infection was not recorded on the death certificate, but she is convinced it did contribute to her mother’s death. Family members are now applying to view medical records to see if they shed light on what happened. Ms McCafferty, of Glasgow, said her mother went into Glasgow Royal Infirmary because of problems with her heart in May 2005. “At that time she was well,” she said. “She was 82, but she was a good 82. She was healthy, a funny and witty woman who was always going out with her friends.”

Ms McCafferty believes her mother became infected with MRSA when a line for medication was put into her groin, but says she has no way of knowing this for sure.

The 44-year-old said it was not until her mother was transferred to the Lightburn Hospital for continuing care that the family found out she had MRSA.

She died in January 2006, with pneumonia recorded as the cause of death.

But Ms McCafferty said she believed MRSA contributed to her mother’s death.

She added: “It was terrible to watch her deteriorate. It was like dementia came over her, brought on when she got infected with MRSA. Towards the end her feet went black. It was awful and now I feel strong enough to try to find out answers to what happened.”

A spokeswoman for NHS Greater Glasgow and Clyde said it was “totally committed” to reducing infections like MRSA. She added: “A range of measures are being deployed to achieve results. An infection control manager and consultant nurse in infection control have been appointed to spearhead the drive to tackle healthcare associated infections.”
http://news.scotsman.com/health.cfm?id=1083572007


One in ten Scottish hospital patients ‘suffering infection’
11th July 2007
LYNDSAY MOSS HEALTH CORRESPONDENT

ALMOST one in ten patients in Scottish hospitals is suffering from an infection such as MRSA, a survey suggested yesterday. The new study - thought to be the most comprehensive ever carried out in Europe - found 9.5 per cent of people in acute hospitals had a healthcare associated infection (HAI). And the cost of such infections to the NHS is thought to be at least £183 million a year.

Experts and campaigners last night said that HAIs continued to be a problem because of poor hygiene in hospitals and a lack of isolation facilities. Professor Hugh Pennington, Scotland’s leading microbiologist, said more attention was also needed to ensure that only patients who needed antibiotics were receiving them to help tackle drug resistance. Nicola Sturgeon, the Scottish health secretary, yesterday pledged to step up efforts to combat HAIs in light of the latest figures, which give the most accurate picture yet of the issue.

This includes the possibility of introducing an MRSA screening programme for those going into hospital. The new report, by Health Protection Scotland, suggested the rate of HAIs is higher in Scotland than the rest of the UK. A study by the Hospital Infection Society from February to May 2006 found that 8.2 per cent of patients in England had an HAI, 6.3 per cent in Wales and 5.4 per cent in Northern Ireland.

Over the same three-month period, the rate in Scotland was 9 per cent.

But experts said the differences in rates were most likely due to the more comprehensive nature of the Scottish survey, which covered every acute hospital and a sample of community hospitals.

The HPS report involved teams going into every acute hospital - 45 in total - and a sample of 22 community hospitals between October 2005 and October 2006. There they counted the number of inpatients over the age of 16 with an HAI who were in hospital on the day of the visit. In total, they found 1,103 patients in acute hospitals had an HAI - amounting to 9.5 per cent of all these patients. Of these, 126 had more than one infection. In the sample of non-acute hospitals, they found 157 patients with an HAI, of which seven had more than one.

Taken across the country as a whole, this could mean more than 1,800 patients in hospital have an infection at one time. The report found that Clostridium difficile was the most common bug among infections where researchers had identified the organism, accounting for 17.6 per cent of cases. This was followed by MRSA (methicillin-resistant Staphylococcus aureus) at 17.2 per cent and MSSA (methicillin-sensitive Staphylococcus aureus) at 8.9 per cent.

The hospital with the highest HAI rate in Scotland was Stobhill Hospital in Glasgow at 18.3 per cent, followed by Falkirk Royal Infirmary at 17.2 per cent. But the reason for the higher rates may be that these hospitals were surveyed during winter, when infections are more common.

Older hospitals have sometimes been blamed for rising rates of infection. But yesterday’s figures showed that this was not necessarily the case. The flagship Edinburgh Royal Infirmary, which opened in 2003, had an HAI rate of 11.6 per cent, compared with 6.8 per cent at the much older Southern General Hospital in Glasgow. Rates also depend on the type of patients treated, with older people more vulnerable. And hospitals also have to deal with patients and their visitors bringing infections in.

Dr Jacqui Reilly, from HPS, said HAIs clearly had an impact on costs to the NHS, adding: “Patients with an HAI stay in hospital 70 per cent longer than those without an HAI.” And she said if infections were cut by 30 per cent, the NHS could save £55 million a year. Ms Sturgeon said this money could pay for an extra 8,000 patients to be treated. She added: “It is not good enough that 9.5 per cent of patients in Scottish acute hospitals have some form of HAI. The £183 million cost to the NHS, together with the human cost of HAI is also unacceptable.”

Prof Pennington said the key to tackling HAIs was to continue with measures already in place, but to do them better.

He added: “At the moment we are just about holding our own, but cases of MRSA are not going down and C difficile is going up. We need to continue to implement policies to control antibiotic prescribing, which contributes to resistance. “The cleaning and hand hygiene must also be a key focus. I am also in favour of screening, but it would need to consider what we do with patients who are carrying the bugs.”

Prof Pennington said Scotland and the UK in general did not have enough isolation facilities to care for patients with an infection, and added that there was evidence of more virulent strains of infections spreading.

Moya Stevenson, of campaign group MRSA Action UK, said it wanted to see screening for MRSA in hospitals. She added: “Bed occupancy rates have to be reduced within our hospitals and this will reduce quite significantly those rates of infections.”

Willie Duffy, from health union Unison, said that the quality of cleaning in hospitals had declined since the introduction of competitive tendering of hospital cleaning in the 1980s and the continuing outsourcing of cleaning at PFI hospitals. He added: “It is no coincidence the lowest levels of HAI in the UK are found where there are the lowest levels of contracting out - in Wales.”

BUGS CAN IRRITATE ... OR KILL
HEALTHCARE associated infections (HAIs) can range from minor skin and eye problems to superbugs such as MRSA and Clostridium difficile.

The Health Protection Scotland (HPS) survey defined HAIs as any infection that occurred two days after a patient was admitted to hospital.

The most common infection which was identified in the study was C difficile, which accounted for 17.6 per cent of cases where the organism involved was identified.

The vast majority of patients with C difficile are over 65. It causes severe diarrhoea and illness and in the most serious cases can lead to death.

The next most common infection was MRSA, accounting for 17.2 per cent of cases. It is one of the most difficult bugs to treat as it is resistant to the majority of antibiotics.

It can cause skin and tissue infection, but is most deadly when it enters the bloodstream.

MSSA - which is related to the same bug which causes MRSA - accounted for 8.9 per cent of infections. Other organisms picked up by the HPS survey included E coli, which can be spread in food. Less common infections also included coliform, enterococcus and candida.

http://news.scotsman.com/scotland.cfm?id=1083682007


HOSPITAL BUGS: OUTBREAK FIGURES RELEASED
clare.boyd@nottinghameveningpost.co.uk

Friday, July 6, 2007

Outbreaks of hospital infections occur almost every fortnight in Nottingham, figures show. And cases of one deadly bug, which causes severe diarrhoea, are up nearly 20% from last year.

Moya Stevenson, an MRSA survivor-turned-campaigner, helped set up MRSA Action UK after contracting it after a routine operation at King’s Mill Hospital, Sutton-in-Ashfield, in 2004. She said: “It is worrying that 340 people who went into hospital to get better were involved in outbreaks of infection. It is a shame in this country that we do not test the environment, the floors, beds, etc, routinely. We have to find where the source of infection is.”


The Dunfermline Press

Thursday 5 July 2007

DIRTY toilets at Dunfermline’s Queen Margaret Hospital could be a breeding ground for deadly super-bugs.

That’s the warning sounded by a leading health campaigner after the Press was given this photograph showing the “worrying” state of a busy toilet at the hospital.

And it came as the Press received a second complaint about standards of hygiene and upkeep at the Queen Margaret.

“I have to say that for a modern hospital the state of the place is appalling,” a reader told us.

At a time when the importance of hospital hygiene has never been clearer because of killer infections such as MRSA and C. diff, the photo above right shows the toilet near the main entrance - used by visitors and patients alike - in a complete mess.

Home care worker Dawn Wallace, who sent us the snap, goes to the hospital cafe for a teatime break and has been disgusted by the state of the toilets.

“For the last six months this has been going on,” she said. “I’d had enough of it the day I took the photograph.

“The paper towels were coming out the door to meet me. They were overflowing out of the bin and were lying all over the floor.

“There were no paper towels left in the dispenser for people to use to dry their hands.

“Patients come down from the wards with their drip feeds for a walk and they use these toilets.

“They could then be taking all sorts of bugs back to the wards.

“It’s also worrying as carers because we’re going into the homes of elderly people.

“One day a member of the public thought we worked at the hospital and started having a go at us over the state of the toilets.

“The point he was making was right because the toilets were a disgrace.”

She added, “Every day I read and hear of stories regarding MRSA and C. diff and the efforts hospitals are making to clean things up.

“I have had a number of negative experiences already at Queen Margaret Hospital wards but was disgusted when two days in a row around 6pm I came across a toilet within the main reception that was clearly not being maintained as it should.

“Patients, visitors and staff were going in and out of here using these facilities and all I could think about was the potential risk of bacteria that was being brought back out on hands and clothes due to the overflowing bins.

“What is going on at this hospital? Surely if we are in a situation where the majority of hospitals are falling below basic standards of required cleanliness they should be making extra efforts.”

Derek Butler, chair of the campaigning charity MRSA Action UK, said, “Toilets in hospitals are a perfect breeding ground for these super bugs.” The group’s president is renowned expert in the field Professor Hugh Pennington and it was set up by relatives of super-bug victims.

“Unfortunately, poor hygiene in hospitals is commonplace throughout the country,” added Mr Butler.

“People are now asking us what is the safest hospital to go into for treatment.

“Unfortunately, we have to tell them the safest place to go is Holland where there is a one per cent chance of picking up an infection in hospital compared to 40 per cent in this country. These, of course, vary in seriousness.”

Mr Butler explained that the strict search-and-destroy policy in Dutch hospitals was very effective but expensive.

“However, it makes more sense than the Government putting aside £1 billion a year to tackle these bugs and another £1 billion for litigation,” he added.

Mr Butler pointed out that the number of hospital cleaners in the UK had halved from 110,000 to 55,000 in the past 15 years.

“Hospitals don’t smell like hospitals these days because they don’t use disinfectant like they used to,” he went on.

“The situation with MRSA seems to be stabilising but they’ve lost control of C-diff.”

A NHS Fife spokesperson said, “We very much regret that the public toilet was not found to be up to our expected standard.

“Although the toilet and sink were clean, unfortunately it appears that used paper towels had been allowed to build up on top of the waste bin.

“We have a set cleaning schedule and do check the toilets regularly to avoid this kind of problem.”

The spokesperson added, “We welcome the feedback and recognise on this occasion there was an issue with the disposal of used paper towels.

“We have already taken the necessary action to monitor the toilets more regularly and intend to get rid of the source of the mess by introducing hand driers.”

However, another visitor to the Queen Margaret has contacted the Press to complain about conditions there.

The reader, who asked to remain anonymous, said, “During the past couple of months I have accompanied my wife on a number of occasions to the out-patient orthopaedic clinic at Queen Margaret Hospital.

“I have to say that for a modern hospital the state of the place is appalling. The waiting area is dark and depressing. Wallpaper is peeling off the walls in numerous places.

“There are a number of badly fitting ceiling panels and their shade of grey (were they white at one time?) combined with the awful cheap-looking strip-lighting adds to the gloom.

“The paint and paper at lower levels of the walls, doorways, etc, is scraped away to the plaster/timber in many places.

“Skirting boards look very dirty and the carpets in the consulting rooms are worn and dirty.

“The whole area gives the impression that no-one in authority gives a damn about hygiene standards, general maintenance or the public’s perception of the place.

“Sadly, from my observations the orthopaedic clinic is not the only part of the hospital that is like this.

“The place has been allowed to deteriorate over the years.”

A spokesperson for NHS Fife said, “The orthopaedic clinic is programmed to be re-located to a refurbished area of outpatients later this year.

“Other clinics within the outpatient area will also have work done to improve the decoration, as part of our on-going annual painting programme.”

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