Epsom and St Helier falls short on hygiene standards

Sutton and Cheam MP, Paul Burstow, has expressed concern that the Epsom and St Helier NHS Trust has failed to meet the healthcare commission's infection control standard for the second year running, when nine out of ten acute trusts met the standard. The standard is one of the three used by the Healthcare Commission to measure the quality of hygiene in hospitals across the country.

Last week (16th June), the Healthcare Commission released a report which focused on checking whether hospitals in the England were complying with the Government's core healthcare standards. The findings of the report showed that Epsom and St Helier met the decontamination of equipment and healthcare environment and hygiene standards. However, the report also stated that Epsom and St Helier could improve on the provision and maintenance of a clean and appropriate environment for health.

NHS Trusts are required to make a declaration to the Healthcare Commission concerning forty-four core healthcare standards. Epsom and St Helier has reported compliance with 43. The Trust chose to declare 'not met' for the infection control standard because it missed its MRSA target for the year.

Burstow commented:

"Some might say that two out of three is not bad. But for the Trust not to meet the infection control standard is very worrying, especially when nine out of ten hospital trusts met the standard. After so many initiatives and so many years when the spotlight has been on tackling hospital superbugs there can be no excuses.

"Hospital infections complicate care, result in longer stays in hospital and can cost lives. Zero tolerance is the only way to tackle the poor practice and bad habits that allow hospital infections to spread.

"Despite not meeting the infection control standard the latest figures for the Trust do show large falls in the number of reported cases of MRSA and Clostridium difficile. That is good news for patients."

ENDS

Information to editor:

In 2006/2007 the Trust failed to meet the infection control standard and could provide insufficient assurance to the healthcare commission on the decontamination of equipment standard.

The information on Epsom and St Helier can be found by following the attached link:

http://2007ratings.healthcarecommission.org.uk/_db/_documents/RVR_Epsom_St_Helier_HC_IR.pdf

The Healthcare Commission's report and the Trust declaration in respect of infection control should be set again the latest figures released by the Health Protection Agency which record that the Trust has:

• Recorded a 60% drop in the number of cases of MRSA bacteraemia found in patients between October and December 2007 compared to the previous quarter;
• Reported an 25% fall in the number of cases of Clostridium

difficile between October and December 2007 compared to the previous quarter.

Below is an extract from the healthcare commission website setting out the standards

Issues: hygiene code, safety, information governance, dignity in care, NICE guidance

1. Compliance with the Hygiene Code

Three standards relate to the hygiene code: C4a (infection-control), C4c (decontamination of equipment), C21 (healthcare environment and hygiene).

The earlier analysis, set out in the section headed "Standards where fewest trusts declared compliance", shows that C4c features for the third year running in the list of standards that trusts most struggle to meet. It is also the standard that showed the greatest decrease in compliance this year.

C4a was one of the standards where trusts have shown the most improvement this year. C21 has also shown some improvement compared to last year.

In total, 72% (280 trusts) declared compliance with all three of these standards that were applicable to them, while 28% (111 trusts) declared non-compliance on one or more of these standards. This is very similar to last year.

Looking at whether the reason for non-compliance was related to the duties of the hygiene code, the Commission found this was the case for:

• one hundred per cent of trusts declaring non-compliance with C4a (35 out of 35)

• one hundred per cent of trusts declaring non-compliance with C4c (70 out of 70)

• sixty four per cent of trusts declaring non-compliance with C21 (21 out of 33 trusts) - note that C21 is about the quality of buildings as well as hygiene issues.

In total, 103 trusts declared non-compliance with one or more aspects of the hygiene code, which is 26% of the total (compared to 25% in 2006/2007). Of these, 41 are acute trusts (24% of all acute trusts), 57 are primary care trusts (37% of all primary care trusts), four are mental health trusts (7% of all mental health trusts) and there

12

was one ambulance trust. Of the 103, 63 were non-compliant last year while 40 have self-declared as newly non-compliant.

The Commission is taking action to enforce the hygiene code through its ongoing programme of inspections on healthcare-associated infection.

Breakdown by sector for hygiene code standards

Primary care trusts (PCTs)

136 out of 152 trusts (90 percent) declared compliance with C4a

105 out of 152 trusts (69 percent) declared compliance with C4c

138 out of 152 trusts (91 percent) declared compliance with C21

Acute trusts

154 out of 169 trusts (91 percent) declared compliance with C4a

146 out of 169 trusts (86 percent) declared compliance with C4c

155 out of 169 trusts (92 percent) declared compliance with C21

Mental health trusts

56 out of 59 trusts (95 percent) declared compliance with C4a

C4c is not applicable to mental health trusts

55 out of 59 trusts (90 percent) declared compliance with C21

Ambulance trusts

10 out of 11 trusts (91 percent) declared compliance with C4a

C4c is not applicable to ambulance trusts

11 out of 11 trusts (100 percent) declared compliance with C21