Hospitals face being served with an “improvement notice” if they fail to tackle superbug infections such as MRSA and Clostridium difficile, the health watchdog announces today.

Inspectors from the Healthcare Commission will carry out unannounced spot checks on 120 NHS trusts in England over the next year in an attempt to cut rates of hospital-acquired illness.

Those that are found not to be up to scratch could find themselves served with an improvement notice or be put in special measures. The crack-down comes after figures which show that cases of C. diff are on the rise.

Health Protection Agency statistics released in April identified 55,681 cases of the potentially fatal bug in patients aged 65 and over in England in 2006 – an increase of 8 per cent on the number of reported cases in the previous year.

The figures also revealed 1,542 cases of MRSA blood-stream infection in England between October and December 2006, down 7 per cent on the previous quarter. Despite the fall, the Government is widely expected to miss its target of halving rates of MRSA before next April.

The Healthcare Commission will use existing data on infection rates and cleanliness to identify trusts that may need help. Those not doing well will be a priority, but up to two thirds of NHS acute trusts will be checked each year as part of the programme. Their performance will be assessed against the Government’s hygiene code, which sets out 11 compulsory duties to prevent and cope with hospital superbugs.

Assessment managers will visit about ten trusts a month, examining their procedures for isolating patients, hand-washing and cleaning equipment. Under the code, trusts must have specialist infection control teams and should submit regular reports to the trust board.

If the code has been breached, trusts will be given a deadline to set out an an action plan for rectifying problems. If they fail to assure the watchdog that appropriate steps have been taken, the commission will publicly issue the trust with an improvement notice.

Failure to comply could end up with the Health Secretary imposing special measures on a trust and personally overseeing an improvement programme.

At present, the commission does not inspect every trust on all the Government’s core health standards. But from this year, the 20 per cent of all trusts inspected will be checked for compliance with the hygiene code. The commission is currently investigating Maidstone and Tunbridge Wells NHS trust after concerns about rates of C. diffthere since 2004.

Last year Stoke Mandeville Hospital, part of the Buckinghamshire Hospitals NHS Trust, was criticised in a commission report after 33 people died after outbreaks there.

Anna Walker, chief executive of the commission, said: “Boards at all acute trusts must take notice: chances are you’re going to be assessed against the hygiene code, so make sure you’re ready. We don’t want to catch trusts out. We would much prefer to find that everything is in place to protect patients and the public.

“The 120 assessments will be in-depth, and visits will be unannounced so that we can see the hospital in action. What we want to know is whether trusts are taking infection control seriously.”

Lord Hunt, the Health Minister, welcomed the move. “Reducing healthcare-associated infections is a top priority for the NHS and all NHS bodies have a duty to comply with the code of practice,” he said.

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