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INDEPENDENT health investigators will launch a blitz on hospital cleanliness amid concerns that the Government has been too slow to act over the MRSA superbug.
Despite pledges to send in “hit squads” to establish which are Britain’s dirty hospitals, no action has been taken. Last year John Reid, the Health Secretary at the time, ordered hospitals to cut rates of MRSA bloodstream infection by half by March 2008.
Now the independent Healthcare Commission has taken the initiative, telling hospital chief executives that it will carry out unannounced assessments of about 100 NHS and private hospitals.
The Commission believes that fears over MRSA (methicillin resistant Staphylococcus aureus) and other hospital bugs are seriously damaging confidence in the health industry.
Andrew Lansley, the Shadow Health Secretary said last night that it was about time that a sense of urgency was injected into the issue of hospital cleanliness. Almost 1,000 deaths a year are directly attributed to MRSA. The number of deaths in which it was a factor have doubled in five years.
The Healthcare Commission, the main regulator for the health service and independent care, plans to name badly performing hospitals in a report to be produced by autumn of this year. Inspectors will give no warning of visits and staff will be expected to co-operate fully in the examinations of wards, outpatient areas and accident and emergency departments.
The commission plans to follow the spot checks with a three-year review of infection and control. Hospitals identified as bad performers will be rechecked again to see if they have cleaned themselves up.
Mr Lansley said: “As long as it is backed up with support from the health department and with the necessary resources and technology to deliver infection control, we might see real progress.”
The move comes as the Government prepares to publish the latest figures on MRSA this week and days before a critical parliamentary committee report on the issue.
Inspectors will go to 100 acute, community and mental health hospitals in both the public and private sectors; there are around 1,000 NHS and 400 independent hospitals in all.
The audit, designed to give a picture of hospital cleanliness in Britain, will concentrate on trusts that have been identified as poor performers. It will also include some of the best performers to show how they have improved standards.
Anna Walker, the commission’s chief executive, said:
“Patients and the public tell us they are concerned about cleanliness. There is a real danger that this issue could damage confidence in healthcare.
“But there is a shortage of facts and this exercise is about getting those facts. That is why we will be sending in our inspectors over the summer. Our aim is to learn from best practice and challenge bad practice.”
Hospitals inspected in the summer audit will be informed of the findings within days to enable them to set up plans for improvement.
In the first year the review will include focus on acute hospitals. In year two, it will move on to primary, community and social care settings in conjunction with the Commission for Social Care and Inspection.This will be crucial in understanding the transfer of infection from care settings to hospitals. In the last year of the review, the commission will assess how hospitals are performing against the government targets set for 2008.
Last week the Government announced that it had asked the commission to hold an inquiry into the spread of the lethal infection Clostridium difficile, which has killed 12 people and infected 300 patients at Stoke Mandeville Hospital.
Government figures show that MRSA cases in England rose from just over 1,000 in 1996 to more than 7,000 last year. It is estimated that hospital-acquired infections strike around 100,000 people each year in England, costing the NHS £1 billion.
Mortality rates were highest among older people, with more men than women dying. MRSA was involved in two in every 1,000 deaths in NHS general hospitals and three in every 1,000 deaths in NHS nursing homes.
Unison, the largest health union, said that the death toll from MRSA may be higher than the latest statistics show, because death certificates still do not always mention MRSA.
The number of death certificates mentioning MRSA rose from 487 in 1999 to 955 in 2003. But this is much lower than the 5,000 deaths each year from hospital-acquired infections estimated by the National Audit Office, based on calculations rather than death certificate evidence.
Some of the increase recorded on death certificates may be due to greater awareness among doctors. Between 2002 and 2003, mentions of MRSA on death certificates increased by 19 per cent and in laboratory reports by 7 per cent.
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