Sadie Gray
We've made some changes
to The Sunday Times
Long-sleeved white coats worn by doctors will be banished from hospital wards because ministers believe that they contribute to the spread of superbugs.
Under a new dress code to be announced today by Alan Johnson, the Health Secretary, the arms of medics must be bare below the elbow whenever they are in contact with patients.
The Government believes that MRSA is spread from patient to patient on the cuffs of doctors’ coats. The guidelines are intended to make it easier for them to wash their hands between cases. The bare-arms rule is one of a number of measures to be unveiled by Mr Johnson to cut hospital-acquired infections such as MRSA and Clostridium difficile.
He will say that the fear of catching a hospital superbug has overtaken waiting times as the public’s greatest concern over the NHS. The initiative comes as a public consultation begins on ways to improve the health service.
Some hospital trusts have already banned white coats, and all are expected to do so by January. Doctors, nurses and other staff will also be ordered not to wear watches or jewellery, and advised against wearing ties while engaged in clinical activity.
A spokesman for the Department of Health said: “The traditional doctor’s coat will not be allowed. Where staff have direct patient contact, then suitable protection, for example plastic aprons, should be worn.”
Matrons and nurses will have a chance to give hospital boards direct accounts of their efforts against superbugs to ensure that their recommendations are not overlooked by managers.
Mr Johnson said: “The problem we have identified is many matrons and nurses tell us they are the experts on how to resolve this problem on their wards, but their voice is not heard clearly enough.”
MRSA cases are down 17 per cent since 2004. Some 6,378 cases were reported between April 2006 and March 2007, the Health Protection Agency (HPA) said. But doctors gave warning last month that poor hospital management practices meant that the Government would miss MRSA targets.
Hospitals will also be issued with new clinical guidance about isolating patients who do become infected with Clostridium difficile, and a new legal requirement will be placed on all chief executives to report all MRSA bacteraemias to the HPA.
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All this talk about sleeves if just a red herring - get rid of contract cleaners and go back to each cleaner being responsible for his/her own ward, cleaners were very proud of their work then - also get rid of these so called matrons and put in a proper matron with ultimate hiring & firing responsibility - when your job is on the line, you'll make sure you wash!!!
catherine, worcester,
As a hospital doctor, I applaud these efforts to reduce hospital aquired infections. In fact, I think they do not go far enough. Any person coming into contact with any patient should be required to wear an apron and gloves, and not just rely on hand washing.
However, there is a fundamental issue not being addressed by the government. No matter how good such precautions are, shared toilets will always be a persistant cause of C.Diff infections. They are not cleaned after each visit, and different patients have vastly different levels of hygiene and personal cleanliness.
Bottom line - they must deal with this too.
Dr Simon Freilich, London,
What about people who have skin diseases and would find it uncomfortable and embarressing to wear short sleeves at work? It is bad enough being stared at when you wish to go swimming or do sports, but at least it is your own choice to do so.
People with bad skin disease have often to choose employment where there is no "uniform" in order that they do not put themselves in this position - this idea would leave yet another option closed to them.
Deborah, South Wales
Deborah Murray, Llantwit Major, Vale of Glamorgan
Speaking as a hospital doctor - i haven't seen a doctor wearing a white coat in hospitals for years - i'm not sure why this is being touted as a story. This reflects badly on the govenment for trying to spin a policy initiative. It also demonstrates some rather casual journalism - pop in to a hospital for yourself and see if you can spot a white coat!
Charlie, Birmingham
charlie moss, birmingham, uk
The General Medical Council is a statutory body that regulates doctors by registering them and disciplining individual doctors by fining, imposing conditions or striking off the register. It does not issue orders about the daily work of the entire profession and can only sanction doctors one at a time. Maybe the ministry can. Otherwise, it would probably have to be Parliament.
Terence Mahoney, MB, BS., Daytona Beach,, FL, USA
Yes, this is a good thing, though I liked wearing my white coat as a hospital doctor in the UK, especially in A&E as it tends to stop unwanted groping and makes you immediately visible.
Patricia, Oslo, Norway
It's been known for years that ties and other items of infrequently washed clothing are ideal vehicles for the transmission of infection. Similarly, it has been suspected that the failure by doctors to wash or otherwise disinfect their hands between patients is likely to spread infection. One simple question, why didn't the General Medical Council - the body through which doctors supposedly self-regulate - long ago impose stringent hygiene requirements and back these up with the appropriate use of sanctions? Poor hygeine standards amongst doctors has almost certainly killed in recent years far more patients that the intentional wrongdoing of doctors such as Harold Shipman. Can we really trust the medical profession to continue to self-regulate when such simple measure appear to be beyond its grasp?
Bev, Oxford, UK
Not having 100% bed occupancy is proven to reduce infection rates. New patients being placed into bed-spaces only just vacated however is the norm. The pressure to do this comes from hospital management (who in turn are acting to fulfill government targets). - Historically this has come from Thatcher-era policies to run hospitals like businesses where 100% occupancy would represent maximum efficiency.
Patients are not placed on the ideal ward for their condition - they are placed into the first available bed - to meet Government 4hour waiting times in Casualty (-sorry "Emergency Dept").
Roly, Sommerset, UK
Very few doctors actually wear white coats these days. I would say as low as 3%. They are hot, uncomfortable and restrictive.
This is actually just a sound bite attention grabbing headline from the government. It is also another drive to undermine doctors and make them appear responsible for the spread of superbugs, again because it is headline grabbing.
As for ties, I think a ban is more driven by political correctness and the idea of spread by superbugs is more theoretical than evidence based.
Dr R Campbell, London, UK
Hygiene has been missing from Hospitals for many years. Nurses wear uniforms but what happened to them being cleaned in boiling water in the Hospital.
It is left to the Nurses, so how do we know they are clean on daily.
They do not wear hats on their heads and you see jewellery worn all the time, which is a known source for harbouring germs. Rubber Gloves are not always worn when attending to open wounds, though have noticed over this last year that they are beginning to.
Matrons were a good source of checking that all was well in the Hospitals.
izzy, wirral, england
Does the Health Secretary know that most doctors don't wear white coats? Perhaps he should arrange to visit a hospital to confirm this for himself.
If he spoke to infection control specialists, he might find that inadequate cleaning of hospitals, patients and hands together with 100% bed occupancy rates and uncontrolled visiting contribute to this problem.
Mark s, london, uk
Congratulations for taking this bold step to reduce HAIs by a fraction of a percent. Perhaps the legions working on this war on cuffs initiative over the past years (as MRSA, C.diff have taken hold) may now be free to improve hygiene enforcement and compliance - i.e. the other 99% of the cause.
steve, essex,