Hospital criticised over 33 infection deaths

Hospital trust criticised over C. difficile outbreak as new figures show the infection is on the rise
Hospital trust criticised over C. difficile outbreak as new figures show the infection is on the rise

The health watchdog has today condemned "serious failings" in the management of an NHS trust, which led to the death of 33 people from a hospital-acquired infection.

The Health Commission's report into two outbreaks of Clostridium difficile (C. difficile) at Stoke Mandeville hospital in Buckinghamshire, in which 334 people became infected, comes as new figures show the bacteria is on the increase.

According to the Health Protection Agency (HPA), cases in patients aged 65 or over increased by 17.2 per cent in England, from 44,107 in 2004 to 51,690 in 2005. It attributes the rise to both improved reporting procedures and a real increase in cases.

However, cases of MRSA, another hospital-acquired infection, fell over the same period - there were 3,517 cases in England between October last year and March, down 2.5 per cent on the previous six months.

Health minister Andy Burham welcomed this development, although he issued a warning to the hospitals who were still failing to tackle the problem of hospital-acquired infections, saying: "Clean, safe care is not an optional extra."

And he said the two outbreaks of C. difficile at Stoke Mandeville between October 2003 and June 2005 were "inexcusable", insisting they could not be allowed to happen again.

"Patient choice means that people will not select treatment at hospitals that do not proactively reduce risk. Patients should be able to expect a good standard of care every time they visit a hospital - this is not optional," he said.

Today's report from the Healthcare Commission finds "serious failings on the part of senior managers" at Buckinghamshire NHS trust, saying they failed to follow the advice of their clinicians, staff and the HPA on how to manage the risk of infections.

It warns they were too preoccupied with their finances, reconfiguring services and meeting government targets to address the issue properly - although commission chief executive Anna Walker insisted central targets cannot be blamed for their failure.

"Let me also be clear that targets are not to blame for the trust's leaders taking their eye off the ball. Managers always have to deal with conflicting priorities and plenty of organisations do it successfully," she said.

The report identified inadequate cleaning, the lack of handwashing facilities, insufficient infection control training and above all the failure to isolate infected patients as the key causes behind the two outbreaks of C. difficile. There was also a shortage of nurses.

However, the Conservatives condemned the government's "complacency" in tackling hospital-acquired infections, saying it was "unacceptable" that patient safety had been compromised by government targets and financial mismanagement of the NHS.

"Patient safety must be a priority and centrally imposed targets should be dropped to facilitate this," said shadow health secretary Andrew Lansley.

The Healthcare Commission acknowledged that when a third outbreak of the infection occurred last December, Stoke Mandeville's reaction showed lessons had been learnt, and this was welcomed by the new acting chief of Buckinghamshire NHS trust.

Alan Bedford said he accepted all the commission's recommendations, but stressed that improvements had been made since the original outbreaks of C. difficile.

In today's HPA figures, he noted his organisation had come 106th out of 168 trusts in the C. difficile infection league tables for January to December 2005, while its recorded infection rates were 26 per cent better than the average on MRSA.


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