One in four NHS trusts is failing the latest government targets on cleanliness and tackling superbug infections, figures published today reveal.

Fewer hospitals and NHS trusts than last year can demonstrate that they are maintaining standards on cleanliness and infection control, despite the introduction of a strict “hygiene code” to eradicate illness caused by MRSA and Clostridium difficile.

Figures released by the Healthcare Commission show that six out of ten trusts in England have reported failing one or more of the twenty-four “core standards” on all aspects of care, on which they are assessed by the NHS watchdog.

Particular problems include failing to decontaminate reusable medical devices, to reduce healthcare-associated infections and to supply the latest recommended treatments for patients. There was also a slight decline in the number of trusts saying they met two standards on treating patients with dignity and respect.

The findings are based on 394 reports by the trusts themselves on their ability to meet the core standards. They show that 40 per cent believe that they met all the requirements in 2006-07, up from 34 per cent in 2005-06.

But 55 trusts (14 per cent) said that they had not met, or lacked evidence to say that they had met, the standard on reducing the risk from infections such as C. difficile, double the 7 per cent from last year.

A similar proportion also said that they had not met, or could not prove that they had met, the standard to disinfect medical equipment properly. In addition, 43 trusts (11 per cent) had failed adequately to keep wards clean and buildings in good order.

Overall, 99 trusts (25 per cent) had failed one or more aspects of a hygiene code, a set of 11 compulsory duties to prevent or cope with hospital superbugsthat was introduced in October 2006.

Inspectors are carrying out unannounced checks on infection control in 120 trusts, and hospitals have been told that they could be served improvement notices if they fail to tackle the bugs.

In April, statistics from the Health Protection Agency (HPA), the public health watchdog, showed that there were 55,681 cases of C. difficile in patients aged 65 and over in England in 2006. That figure was up by 8 per cent on 2005.

MRSA bloodstream infection figures revealed 1,542 cases in England between October and December 2006, down 7 per cent on the previous quarter. Despite this fall, the Government is expected to miss its target of halving MRSA rates before next April. Today’s report lists 15 trusts who know that they will get a “weak” rating in this year’s check by the Healthcare Commission. They have already said that they cannot meet 14 or more of the 24 requirements on care.

Four trusts did not meet any of the three standards relating to the hygiene code, the commission said. These were the Royal Cornwall Hospitals NHS Trust, Sheffield Primary Care Trust, Sutton and Merton Primary Care Trust and Wiltshire Primary Care Trust.

The Royal Cornwall was identified this month as being in financial difficulty when the Government published figures on NHS deficits.

A further one in ten trusts could not say that they conformed to guidelines regarding recommended new treatments and medicines.

The commission will now investigate one in five NHS trusts in England before publishing its final report in October.

Anna Walker, the commission’s chief executive, said that there were several possible reasons for the failures on hygiene, but the commission wanted to “applaud trusts that have put their hands up” and declared failures. “The first step to sorting out a problem is recognising you have one,” she said. “That is the action of an honest and responsible board that wants to make improvements and get these standards in place for patients.”

Opposition parties called the findings uanacceptable. Norman Lamb, the Lib Dem health spokesman, said: “There has to be a cultural change within hospitals. Three quarters are successfully implementing effective measures – there is no excuse for others not to follow.

“There has to be a zero-tolerance approach to tackling superbugs. It is shocking that, after countless government initiatives, the number of hospitals failing to protect patients from these infections has doubled.”

A Department of Health spokesman said: “It is encouraging that, for many standards, over 90 per cent of trusts were able to report compliance . . . Where there is evidence of a problem, it is important that individual organisations ensure that they have plans and processes in place to improve.

“The review process will help the trust to develop solutions with their SHA, and this is part of the declaration process.”

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