Opinion Former Article

As reductions in MRSA and Clostridium difficile plateau nationally, new measures to target poor performance will be brought in, says MRSA Action UK

MRSA Action UK's analysis of figures from the Health Protection Agency show that the measures that have been so successful in reducing the numbers of infections reported to the Health Protection Agency are working. However there are still some hospitals that are no longer seeing the reductions that the best performing hospitals are.

Under a new regime hospitals where an MRSA bloodstream infection have occurred will be required to undertake a post infection review to see where things went wrong. There may be financial penalties incurred if the infection was avoidable.

Also under review is the flagship universal MRSA screening programme. We have yet to see the report on the national one week study undertaken in 2011 to assess the outcome of universal screening for MRSA. MRSA Action UK was shut out of the process by Department of Health civil servants, who have now refused to give details of the outcome of the study. The charity did raise issues with the methodology employed when news of the research reached them from another source.

Not a week goes by without information being requested from members of the public on a positive screen, either by direct contact or through use of the charity's website. Anxiety about positive screens was something that the research did not cover. The concerns on the impact of people with dexterity problems being able to carry out decolonisation if they were found to be positive were not addressed or considered. This could have implications if it was believed that decolonisation had taken place in an effective manner.

The aim of the research was to see how cost effective it was, and a published summary suggested that universal screening is not cost effective and targeted screening, including screening for MSSA - the strain of Staphylococcus aureus that is responsive to the Meticillin group of antibiotics, may be more cost effective.

Civil servants have refused to disclose the cost allocated to the research and have also refused to disclose how many NHS Trusts responded to the 60 plus questions on screening. Our charity based a Freedom of Information request on the questions asked in the survey and were told it would cost £600 to provide the answers to the questions. The findings were supposed to be published last summer but have been delayed until later this year.

There is still work to do on other infections in hospitals and care facilities as highlighted in the Health Protection Agency English National Point Prevalence Survey on Healthcare Associated Infections and Anti-Microbial Use 2011 report. The priority areas identified as needing action include sustained education of clinical staff, the development of learning tools for the prevention and surveillance of pneumonia and a review of surgical site surveillance. The priority area for anti-microbial use is the development of antimicrobial stewardship and prescribing competencies.

The areas identified will need to be considered carefully by individual healthcare and professional organisations and the Department of Health so that an action plan can be developed to halt avoidable infections and save lives and unnecessary suffering.

Derek Butler
MRSA Action UK
email: derek.butler@mrsaactionuk.net
telephone: 07762 741114

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