Meeting with Greg Beales, Health Adviser Terracotta Room 10 Downing Street October 18th 2007 3:00pm   MRSA Action UK had extended an invitation to the newly appointed Prime Minister Gordon Brown, along with all Members of Parliament to attend the Innocent Victims Memorial on 19th July 2007.  We received an apology as due to other commitments on that day the Prime Minister could not attend.   As a follow up we wrote to the Prime Minister to ask for a meeting, and received a communication from Greg Beales, Health Adviser to the Prime Minister, who was particularly interested in the press release and reference to the "search and destroy" policy.  We duly contacted the office and met with Greg Beales at No.10 on October 18th 2007.

Summary of meeting

In attendance:

Greg Beales, Health Adviser

Derek Butler, Chair, MRSA Action UK

Maria Cann, Secretary, MRSA Action UK

We were shown to the Terracotta Room and met informally with Greg Beales who explained that he and the Health Secretary Alan Johnson were interested to hear our ideas, and invited us to talk.

We outlined the need for behavourial changes and a systematic approach to the way the wards were managed.  100% compliance with hand-hygiene was essential, and we had just come from the year 3 launch of the cleanyourhands campaign, where Sir Liam Donaldson had reiterated this, there was no room in the NHS for people who would not comply.  Doing things right first time every time in a systematic way was an ethos that needed adopting throughout the healthcare setting.

It was encouraging that the Government had announced screening, but this needed to go further.  If there were high incidence of healthcare infections staff needed screening too.  As the Dutch do.  This included screening for Clostridium difficile.

Decolonisation needed to be done in a systematic way as the microbes build up resistance to treatments, it was important therefore to do the surgery on the fifth day.

There had to be a holistic approach to care that followed the patient throughout their journey.  The screening was needed on discharge as well as prior to admittance as there was a growing problem with healthcare infections in the community.

We explained the Dutch policy of "search and destroy", how it had evolved in the UK but there were not enough isolation facilities here to roll this out nationally, the Dutch ran with it, we gave up.  We now have the problems they don't.

We needed the same approach as the Dutch, the microbes are in the environment and we need the technology to combat it, such as UV air filtration and other technologies that exist to fight the microbes on touch surfaces.

Bed occupancy rates were much lower allowing time to clean and care.

Our views on the £50m spend on steam cleaning were that a twelve-month programme was not enough in isolation.  We named good practice we had found on visiting hospitals like Bedford where regular decontamination of beds, commodes, cleaning equipment took place.  The bio-decontamination was essential where there were outbreaks but this needed doing systematically, and thorough cleaning after every patient was necessary with all equipment.

Giving power back to the Matron was welcomed; the approach of non-contract compliance to get the quality of the cleaning was good.  We favoured in-house cleaning as the cleaners would be part of the "family" in a well governed hospital.

Cleaning was an important marker for patients and staff, it was a sign of a well-managed hospital.

We should also learn from the Dutch and others with a rational approach to antibiotic prescribing.

More research was needed on the value of probiotics as the approach of prescribing probiotics to patients who have to have antibiotic treatment is being considered more and more.  The jury should remain open on this until there is robust conclusive research conducted.

We felt the meeting was useful as it gave an opportunity to air our views on what we knew worked well, the dialogue remains open.

For more information contact Derek Butler

Email: derek.butler@mrsaactionuk.net