Quarter Of NHS Trusts Miss Targets For Superbug

One in four NHS trusts in England admit they are failing to comply with hygiene regulations introduced last year to halt the spread of MRSA and other hospital superbugs, health inspectors have disclosed.

The Healthcare Commission said 99 of the 394 trusts confessed to not meeting all the standards included in a compulsory hygiene code introduced by health ministers last October.

Self-assessments by the trusts show widespread hygiene problems, including failure to decontaminate reusable medical equipment. Hygiene failings were admitted by 38 hospital trusts, the ambulance service in Yorkshire, Staffordshire and the South-East Coast areas, mental health organisations and primary care trusts.

Some trusts failed on several hygiene standards, but 25% failed on at least one, prompting concerns from opposition political parties. Andrew Lansley, the shadow health secretary, said: “We congratulate those trusts which have successfully complied, because I know how much hard work that would have required. The one in four yet to meet the code need to realise that it is an imperative, not an option.”

Norman Lamb, the Liberal Democrat health spokesman, said: “It is wholly unacceptable that one in four hospitals are still failing to meet required hygiene standards…It is shocking that after countless government initiatives the number of hospitals failing to protect patients from these infections has doubled. Hospital staff should treat failure to comply with hygiene standards as a very serious issue, akin to gross misconduct.”

The commission said 14% of trust boards were unable to sign a declaration that they “keep patients, staff and visitors safe with systems to ensure risk of healthcare-acquired infection to patients is reduced”, a failure rate almost double the percentage in last year’s return.

Other lapses included 14.3% of trusts that could not say they “properly decontaminate all reusable medical devices and manage well the risks associated with decontamination facilities”. About 11% of trusts did not meet standards on maintaining a hygienic environment and 8.4% did not have systems to ensure medicines were handled safely.

Anna Walker, the commission’s chief executive, said the apparent deterioration did not imply that the NHS was becoming less safe for patients. The standards were included in a hygiene code imposing 11 compulsory duties on trusts to prevent the spread of infection. This concentrated the minds of trust directors and may have made many realise their systems were not as secure as had previously been thought.

The Department of Health had claimed it was starting to win the battle against the superbugs. In the final quarter of last year, 1,542 patients had MRSA infecting their bloodstream, 7% fewer than in the previous quarter. An increase in numbers of older people infected with Clostridium difficile was also beginning to slow.

But the admission by 99 trusts that hygiene systems are still defective shows the battle is not yet won. They included foundation trusts such as Moorfields Eye hospital in London, Newcastle upon Tyne hospitals and County Durham and Darlington NHS trust. The confessions came in the annual self-assessments by trust boards about whether or not they met 44 quality standards covering every aspect of healthcare delivery.

About 44% claimed full marks on all the standards, compared with 34.4% last year. And 85.3% met at least 40 of the standards, compared with 74.4% last year. The fastest improvers were hospitals in London and the south-east. Inspectors will visit a sample of trusts over the next few weeks to establish whether the self-assessments are accurate.

The commission labelled 15 trusts as “weak”, for failing on at least 14 standards. They were: Royal Cornwall hospitals; Buckinghamshire hospitals; North Devon Healthcare; Cornwall Partnership; Surrey and Sussex Healthcare; Yorkshire ambulance service; and the primary care trusts in Eastern and Coastal Kent, Cumbria, East and North Hertfordshire, West Hertfordshire, Sutton and Merton, North Lancashire, Devon, Wiltshire and Surrey.

Ms Walker said: “We want to applaud trusts that have put their hands up and declared non-compliance in some areas.” Trusts knew that hygiene and patient safety were under the spotlight, she said. “They are looking at these issues more thoroughly. From the point of view of patients, that is good news.”

The commission will carry out unannounced spot checks on 120 trusts during the next 12 months to establish whether adequate hygiene standards are in place. Those that are not up to scratch could be issued with an improvement notice or be put under special measures.

Gill Morgan, chief executive of the NHS Confederation, said: “Where trusts have declared they are not meeting a particular standard this shows that boards are really examining their own performance. By recognising that they need to do more, trusts are taking the important steps towards delivering excellence for patients.”

The Department of Health said: “It is encouraging that for many standards over 90% of trusts were able to report compliance. Where there is a problem, it is important individual organisations ensure they have plans in place to improve.”