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Press articles from October to December 2007

Doctors told to get rid of their white coats

The Telegraph - Last Updated: 2:55am GMT29/12/2007

Doctors will be banned from wearing white coats, ties and long sleeves from next week as part of the fight against superbugs in hospitals.

Under the “bare below the elbows” scheme, doctors and nurses in England will also be banned from wearing watches or jewellery at work. The move has been welcomed, but some campaigners said it did not go far enough to protect patients.

Derek Butler, the chairman of MRSA Action UK, said: “No medical staff who deal directly with patients should go out of the hospital with their uniforms on. It increases the risk of community-acquired infections.”

Dirty Tourniquets Reused In Hospitals
Dec 24 2007 By Bob Dow

SCOTLAND’S top virus expert has hit out at hospitals re-using dirty tourniquets.

Professor Hugh Pennington said patients were being put at risk by the straps used in taking blood samples.

The microbiologist said: “We are letting infections like MRSA in through the back door with practices like this.”

His blast came as it was revealed Aberdeen Royal Infirmary had put 21,000 patients at risk by reusing the tourniquets.

A medical journal study found some - encrusted with blood - had been used again and again for up to four years without being cleaned.

Professor Pennington, who has helped a number of major infection probes, said urgent checks should now be carried out at all hospitals.

The Aberdeen University expert said: “I think it is one of those things that nobody has paid too much attention to over the years.

“People have being going around taking blood in the wards for about 15-years and I don’t think anyone saw it as a real problem until now. Clearly, we have to do a risk assessment to find out if all hospitals have the same problem.”

The study did tests on all 50 tourniquets used at ARI and found some had the potentially fatal MRSA superbug. The hospital had 1670 MRSA cases last year.

The professor said: “It has been suggested using disposable tourniquets. They would be absolutely safe and get rid of the problem at a stroke.”

He warned: “I would be surprised if we didn’t find the same sort of thing in other hospitals and we need the same solution for them all. I am surprised that some of these bandages were manky. You would think having blood on them would be a good signal to throw the bloody things away.”

The charity MRSA Action UK described the study’s findings as “disgusting”.

NHS Grampian said they had not yet seen the findings but added they had procedures in place to prevent the spread of infections.

Meanwhile, it has been revealed surgeons are using hearts of former drug addicts for transplants due to an organ shortage.

A total of 450 organs of all types over a five-year period came from donors with a history of drug abuse

http://www.dailyrecord.co.uk/news/scottish-news/2007/12/24/dirty-tourniquets-reused-in-hospitals-86908-20265180/

FILTH OF “THIRD WORLD” HOSPITAL
Sunday December 23,2007

BLOODY bandages encrusted with deadly MRSA have been used repeatedly in a hospital - threatening 21,000 patients.

Politicians have demanded an inquiry after a study found two thirds of tourniquets were never washed, most were soiled or bloodied, and some were re-used for four years.

Patients were placed at risk of catching a superbug, say microbiologists who found that one in 20 tourniquets carried the potentially fatal MRSA virus.

MSP Mary Scanlon, the Scottish Tory health spokeswoman, yesterday said the probe into Aberdeen Royal Infirmary was “shocking”.

She added: “It is something people would expect in a Third World country or on a battlefield, not in the frontline of an NHS costing billions of pounds a year in Scotland.

“At the very least, Scottish patients are entitled to expect unsoiled bandages and tourniquets without bloodstains.”

The findings, which will be published in a medical journal next month, were uncovered following tests on all 50 tourniquets being used at Aberdeen Royal Infirmary.

Scientists at Aberdeen University said the hospital had a “significant problem” with MRSA with 1,670 cases a year. They found the bandages - used for raising veins in the arm so blood samples can be taken - were being used for an average of 42 weeks, with at least one spending 208 weeks on the wards.

They had come into contact with around 21,000 patients, with 62 per cent soiled, four per cent bloodstained and a further four per cent soiled and bloodstained.

The researchers have urged hospital officials to bring in disposable bandages. Professor Hugh Pennington, who was not involved in the study but is a microbiologist at Aberdeen University, yesterday said there would be a “serious risk” of an infection passing from the bandage into the bloodstream.

Prof Pennington added: “Even if people are washing their hands, if the tourniquets are contaminated then it blows away all the other controls.

“They haven’t got time to disinfect the tourniquet between each patient but by using reusable tourniquets you would get rid of the risk altogether.”

Former minister Ross Finnie, now the Lib Dem health spokesman, said the findings are a “clarion call” for every health board.

He added: “Everyone expects the highest degree of cleanliness in our hospitals, therefore it is highly disturbing that this report should reveal a degree of failure to cleanse properly that seems quite incredible.”

According to official figures, deaths from MRSA have increased by more than a third over the past year, from 38 in 2005 to 51 last year. However, experts fear the true figure could be ten times higher.

Hospital-acquired infections such as MRSA and Clostridium Difficile are estimated to cost the NHS in Scotland at least £183million every year.

David Hardie, 60, believes an MRSA infection contracted at Aberdeen Royal Infirmary contributed to his wife Noreen’s death in August.

The 61-year-old had an operation on a dislocated hip. Mr Hardie, an off-shore worker, from Millbrex, Aberdeen-shire, said: “The last time I went up to see my wife in hospital, I was sitting at the side of the bed and the amount of stuff lying on the floor was ridiculous. There were syringes lying about, bits of paper taken off bandages and it wasn’t even any distance from the bin. The place was just manky.”

Derek Butler, chairman of charity MRSA Action UK, described the findings as “disgusting”. He added: “All bandages should be washed and sterilised irrespective of what they are used for. That should be normal practice for any modern medical facility.”

The Scottish Government said a task force has been set up to reduce hospital infections, and stressed £54million will be spent on fighting the bugs over the next three years.

A spokesman said: “Patients and the public rightly expect the highest standards of hospital cleanliness and we are determined to drive down hospital infections, and ensuring that hospitals have ever higher standards of hygiene cleanliness is a key part of that.”

Officials at NHS Grampian yesterday said they had not seen the study but “look forward” to reading the findings.

A spokesman added: “Like all hospitals, we have procedures in place for tackling the spread of infection, which we take very seriously.”

MRSA deaths soar by a third in only a year

By LYNDSAY MOSS HEALTH CORRESPONDENT

15th December 2007

DEATHS caused by the hospital superbug MRSA have increased by more than a third in only a year, The Scotsman can reveal.

In 2006, there were 51 deaths in which MRSA was recorded as the main cause - up from 38 the previous year. In total, 213 death certificates mentioned MRSA as either the underlying cause or a contributory factor.

But the microbiologist Professor Hugh Pennington said the real extent of deaths linked to the superbug could be ten times higher than the official figure.

The latest figures on MRSA, from the General Register Office for Scotland, come after The Scotsman revealed in October that deaths from the Clostridium difficile bug had soared by more than 60 per cent last year, leading to 164 deaths. Campaigners last night called for greater efforts to combat hospital-acquired infections and better recording of deaths involving MRSA.

Linda McCafferty, of the campaign group MRSA Action UK, said she feared the actual number of deaths was even higher than that recorded.

“My mother, Nellie, had MRSA and it was not recorded on her death certificate,” she said.

“I think there are a lot more deaths and it is just not being recorded. Doctors need to be making sure MRSA is recorded, whether it is the main cause of death or a contributory factor.”

She went on: “There are people who are scared to go into hospital because of these bugs. It is something that people are really worried about.”

Prof Pennington, Scotland’s leading microbiologist, said he suspected there was “significant under-reporting” of MRSA. “The whole process of death certification is basically flawed,” he said. “I would not be surprised if we did a proper study of all deaths in a hospital that we would find the actual number involving MRSA was ten times higher.

“I would like to be proved wrong, but I think a tenfold estimate is a good working hypothesis.”

The Scottish Government is to introduce an MRSA screening programme for patients going into hospital. It has also announced a multi-million-pound fund to reduce infections in hospitals.

Nicola Sturgeon, the health secretary, said: “It is concerning that there has been a rise in reporting of deaths where MRSA was considered to be the underlying cause of death. This should be seen in context, however, and it is most unusual for MRSA infection to be an isolated cause of death - a range of contributory illnesses are normally involved.”

She said the Scottish Government took tackling hospital infections “extremely seriously”, which was why it had earmarked £39 million for MRSA screening and a further £15 million over the next three years to tackle hospital infections.

http://news.scotsman.com/health/MRSA-deaths-soar-by-a.3593620.jp

Warning: the ‘superbug’ is spreading fast

LYNDSAY MOSS

Tue 27 Nov 2007

PATIENTS carrying MRSA are taking the superbug out of hospital and spreading it in the community, a study has revealed. Researchers now believe patients should be tested for MRSA when they leave hospital to halt infection levels. A study at Aberdeen Royal Infirmary found that incidents of MRSA diagnosed in the local community increased with a rise in cases at the hospital. The research, published in the Journal of Hospital Infection, estimated that for every ten cases of MRSA occurring in hospital, there would be one extra case in the community a month later. Dr Ian Gould and his colleagues suggested that patients could be tested for MRSA when they left hospital to stop it spreading in the community.

The research gives extra ammunition to campaigners angered by claims that rising MRSA in hospitals is caused by patients bringing it in. Gould says they estimated that between 5 per cent and 10 per cent of patients discharged from hospital could be carrying the MRSA bug without showing any symptoms. Their study found peaks and troughs in MRSA found in the community linked to the number of cases in hospital.

Scotland is set to start screening patients for MRSA when entering hospital. But the Aberdeen study suggests this could be taken a step further. “Screening at patient discharge should be tested as a new measure to help control spread of MRSA in the community,” the researchers say. Gould adds: “The vast majority of MRSA in the UK is almost certainly acquired in hospital or nursing homes, but as nobody has ever published data from discharge screens we don’t know figures. “I have estimated that between 5 and 10 per cent of discharges could be MRSA- positive in hospitals with major MRSA problems.”

Gould says that hospitals were probably reluctant to screen for MRSA on admission and discharge because it may provide “ammunition for litigation” among patients who are found negative on admission but positive when leaving hospital. “But it would certainly give us a good idea of the real size of the cross infection problem,” he says.

Gould adds that if a patient was found to be carrying MRSA when being discharged, they would not have to stay in hospital. Instead, they could be cleared of the bug using treatments at home. Gould says that the United States already had a major problem with community acquired MRSA. “The fear is that this will happen in UK some time soon,” he adds.

Hospital acquired infections (HAIs) such as MRSA and the even more deadly Clostridium difficile have certainly become a major focus in Scotland and the UK as a whole. Figures suggest that such infections cost the NHS at least £183 million a year, with patients needing extra treatment and longer stays in hospital. But coming up with new ways of tackling infections in an effective way has not proved simple. Dr Alistair Leanord, the director of the Scottish Infection Research Network, which aims to improve research into healthcare-related infections, says screening patients on discharge would need to be closely examined.

“This is something we would have to consider very carefully before introducing it. We have to look for what is going to give us the biggest bang for our buck. With scarce resources it is something we would have to examine closely,” he says. Leanord says there was a concern about growing cases of MRSA in the community - both those linked to hospitals and a different strain of the virus, known as community acquired MRSA. “As well as cases of hospital associated MRSA going out in the community, we are also seeing more cases of a different strain of community-associated MRSA,” Leonard says. “This is in people who have no reason to be carrying MRSA because they have not got links to hospital or healthcare settings. These are two very distinct problems but both need to be examined.”

Linda McCafferty, a Scottish representative of MRSA Action UK, says the charity would welcome any measure to cut the suffering caused by MRSA.

“People will be screened when they go into hospital and they are found negative,” she says. “But when they get screened later on they are positive for MRSA but the hospitals won’t admit where they got it from. They often say it is the patients bringing it in, but they are also taking it out.”

Dr Jean Turner, of the Scottish Patients Association, says messages on good hygiene in hospitals needed to be “ingrained” in staff. “The feedback I have had from patients is that all the good practices have been lost by the wayside either because of not enough nursing staff or people not dedicated to the area of cleanliness,” she says. “It seems these practices have not been ingrained in them.”

The research undertaken at Aberdeen Royal Infirmary came after Pulse magazine reported that the Department of Health in London is to set up a “robust and comprehensive” MRSA surveillance system at GP surgeries after researchers found a “very large” increase in hospitalisations related to the bacteria.

http://news.scotsman.com/health.cfm?id=1856092007

MRSA Action UK Press Release 27th November 2007
Challenges for the Lord Darzi’s Review of the NHS

MRSA Action UK outlines the Challenges for the Darzi Review as the 60th anniversary year approaches for the NHS, we believe that whilst there is much to celebrate in our health service Patient Safety remains the biggest challenge in Lord Darzi’s Review of the NHS, and we welcome the opportunity to be part of the process. We will set tough challenges.

The NHS must rise to the challenge of safety in quality of care, whilst aspiring to provide care responsive to people’s needs and to keep pace with rising public expectations and new medical technologies.

Lord Darzi’s review gives an opportunity for consultation with staff and patients, and is an opportunity to engage NHS staff and the public, in designing a health service fit for the 21st Century.

In terms of quality and safety this must include measures to keep our systems safe throughout the patient journey, that is prior to any hospital admission and after they have left the Acute care setting. We believe that there has not been enough emphasis on the systems that are in place to mitigate risks from inappropriate treatment and the exposure to some of the more virulent strains of hospital acquired infections that we are witnessing. Indeed these are now as great a scourge in the community, with Care Homes falling victim to something that originated within the hospital setting.

It is encouraging to see there will be major investment in GP practices, and this is usually the start of the patient journey and the place where there is the greatest opportunity to initiate the controls necessary to ensure that patients are aware of any risks and that all the measures are in place to mitigate risk from healthcare infections. Better information for patients is a must, and will play a huge role in ensuring they stay safe, and boost their confidence in their NHS. Patients need to be told that there is an awareness of the fear and anxiety that is around in the current climate of rising infections in many of our hospitals. They need to know that there will be a shift to making the environment safe and how they can play their part in staying safe.

Whilst we should be able to rely on healthcare professionals to do the right thing right every time, letting the patient know what the right thing is, this is another way of “error-proofing” the system. This is why we feel it is important to involve patients in the design of their care.

Lord Darzi’s work has led to the announcement of £130m of investment to ensure that all admissions, elective and emergency, are screened for MRSA, however there is no mention of the screening of NHS staff - we believe screening should be carried out throughout the patient journey to close the loop on hospital acquired infection and colonisation and stop this entering the community setting. The £140m aimed at reducing C difficile infection rates needs a targeted approach, there are at least 50 Acute Trusts that continue to see an increase in C difficile, some of whom have higher rates than Maidstone and Tunbridge Wells. Hospital cleanliness should be the last concern of patients and the first concern and duty of everyone in the health service, not least to reduce the risks from the spread of C difficile.

We welcome the £100m fund for innovation, and the establishment of the new Health Innovations Council to give the opportunity of scientific and technological advance. We need to ensure that all the developing technologies are available to provide a holistic approach to making it safer for patients, particularly in relation to the environment within the healthcare setting. We believe more research on antimicrobial resistance and the development of existing technologies, such as the use of probiotics and vaccines is needed.

The public demanded more money for the NHS and patients need to know it is to be well spent. The extra investment must focus uncompromisingly on improving quality, safety and access, making quality and safety the number one priority throughout the patient journey, patients must know that there will be accountability in the NHS, and there will be no room for the complacency and acceptance of the horrific standards witnessed in Maidstone and Tunbridge Wells.

As a Charity we have a responsibility to ensure that the patient perspective is represented and that we will always put safety and quality first in the challenges we put to the Government and the Department of Health.

Derek Butler, Chair MRSA Action UK

Plan would give UK patients free care in EU
Telegraph article
By Laura Donnelly, Health Correspondent

Last Updated: 12:01am GMT 25/11/2007

British patients will be able to go anywhere in Europe for free health care under radical laws being drawn up by Brussels.

Border restrictions on medical treatment will be lifted, officially sanctioning “health tourism” to and from the Continent.

Britons travelling abroad for health care, ranging from dental work to open heart surgery, will have their treatment funded by the NHS. They will simply have to pay their travel and accommodation costs, plus any top-up fees if charges in the foreign hospital are higher than NHS costs.

Andrew Lansley, the shadow health secretary, said the number of British patients likely to seek care abroad would prove an “indictment” of the Government’s record on health care, with the spread of hospital infections in Britain likely to be the key concern of those seeking treatment elsewhere.

Katherine Murphy, from the Patients’ Association, described the plans as “a wake-up call to the NHS to put its house in order”.

Under the European Commission proposals, to be released by the EU next week, patients from the Continent will also be able to have access to NHS hospitals.

Health experts said that they expected more health “traffic” to flow out of the UK than into it because of the poor reputation of the NHS on dealing with infections and waiting times.

The plans say that patients should not be given drugs or treatments that their own state system does not fund, and that where there are waiting lists, domestic patients should have priority over foreign patients. Beyond that, EU residents would be free to travel for non-emergency care in any of its 27 countries.

Next week’s directive is an attempt to catch up with a series of European court rulings over the past decade which have ruled that there should be an open market in health care across Europe.

A court case involving a British pensioner, Yvonne Watts, who went to France for a hip operation, last year confirmed the legal right of patients to seek treatment abroad if they had to suffer an “undue delay” at home.

In the past five years, more than 3,000 patients have travelled to Europe for care paid for by the NHS, but as waiting times have fallen, the numbers have dropped.

But the new plans will say that anyone living in the EU should be able to travel to another member state for health care, regardless of their reasons, following earlier court cases which established that health should be part of a European “free market”.

The new laws are not intended to give extra rights to Britons living abroad who fall ill - in those cases restrictions are tightening - but only to those who arrange a trip abroad specifically for health care. The proposals will increase the pressure on France following its recent decision to deny state health cover to British expatriates on early retirement.

Mr Lansley said: “I think the Government is very fearful that patients will vote with their feet, and that this will be an indictment of the way they have run the NHS.”

Andrew Haldenby, the director of the think-tank Reform, said that he expected thousands of people to take up the option of state-funded health care “for the price of a journey on Eurostar and a cheap hotel”.

Last week, in a written answer, Dawn Primarolo, the health minister, said that the Government would “work to protect the UK’s interests”, stressing the need for any new laws to be “proportionate”.

Derek Butler, the chairman of the charity MRSA Action UK, said the ruling would “open the floodgates” to Europe for British patients seeking to escape its high rates of hospital infections. “I think this is brilliant news. Many people are terrified of getting MRSA and Clostridium Difficile and if they had the choice they would definitely go elsewhere.”

BBC NEWS
Nurse struck off for MRSA failure
Last Updated: Friday, 23 November 2007, 11:06 GMT

A woman has become the first nurse in England to be struck off for failing to wash her hands after treating a patient with MRSA

Yvonne Zanele Cemane, 53, was found guilty of six allegations of misconduct by the Nursing and Midwifery Council. The nurse, from Birmingham, worked at Rylands Nursing and Residential Home in Newport, Shrops, from May to July 2005.

She was also found to have roughly treated a man and demonstrated a “lack of basic anatomical knowledge”. Cemane failed to wear a protective apron while treating the patient with MRSA and did not remove her gloves afterwards.

‘Public confidence’

Leila Harris, Nursing and Midwifery Council (NMC) spokeswoman, said the failure to wash her hands after treating the MRSA patient had been a contributing factor in the panel’s decision. “There were a total of six charges (proven) and that happened to be one of them.

“It’s the first time that has contributed to somebody being struck off,” she said. Michael Summers, vice-chairman of the Patients Association, said: “All nurses are well aware of the need to ensure that not only do they protect the patient, but other members of staff from the infection spread.

“They (NMC) have taken a very serious view, as do we, of the allegations against this nurse, which included the risk of spreading MRSA and not taking proper action to hand washing.”

Cemane, originally from South Africa, did not attend the hearing on Tuesday. Panel chairwoman Catherine Duthie said: “The appropriate and proportionate sanction to impose in this case is that the respondent be struck off the register.

“No lesser sanction would be appropriate, having regard to the panel’s duty to act in the public interest and to preserve public confidence in the profession.”

The allegations proven against her were: An incorrect entry in the care plan of a patient, failing to record the administration of medication, failing to ensure medication was taken, using the wrong dressing to treat a wound, failing to wear an apron, remove gloves or wash her hands after treating a patient with MRSA and roughly handing a patient and acting inappropriately when attending to him.

Telegraph magazine
10 November 2007
Talking point: How can we avoid hospital superbugs, asks Judith Woods

Most people admitted to hospital feel some degree of trepidation, but these days their concern is as likely to focus on the risk of acquiring a superbug as on their condition.

Last month Gordon Brown revealed a raft of new measures, including a “deep clean” directive, designed to combat the spread of life-threatening bacterial infections - and with good reason.

Craig Venter, the American genetics pioneer, said recently that “superbugs pose a greater threat to humanity than bioterrorism.”

Although MRSA has been better know, the antibiotic-resistant Clostridium difficile has recently overtaken it as the biggest infection danger in hospitals. It recently made the headlines with shocking reports of filthy condition in three hospitals run by the Maidstone and Tunbridge Wells NHS Trust where, between April 2004 and September 2006, the bacterium directly caused the deaths of 179 more.

The C difficile bacterium causes infectious diarrhoea, dehydration and inflammation of the gut, and affects about 66,000 patients a year, leading to almost 3,900 deaths, mostly among the elderly. It is caused by inadequate infection control, poor standards of hygiene, overcrowding on wards and the overuse of drugs: using antibiotics kills off “friendly” bacteria in the gut, which naturally keep C difficile in check. The bug forms spores which must be removed using soap and water rather than alcohol gel, making it harder to control than MRSA, which affects about 6,400 patients annually.

More than 1,600 people die from MRSA every year in England and Wales, and Britain has one of the highest rates of infection in Europe. Although the latest figures show a fall of about 17 per cent since 2004, experts believe the true number is probably higher.

Millions of healthy people carry MRSA harmlessly, but when a person’s immune system is weakened, or the bacteria are spread to an open wound, either through sneezing or on the hands, they can cause sever and sometimes fatal infections, as they are highly resistant to antibiotics.

The good news is that MRSA can be tackled with conventional soap and water; the bad news is that medical staff don’t wash their nearly as much as they should. According to a report by the Healthcare Commission, 99 NHS Trusts - one in four of the total in England - have admitted that they are failing to meet minimum hygiene standards, and an estimated 60 per cent of medical staff across the entire NHS don’t wash their hands between patients.

“The NHS has failed to get a grip on infection control,” says Kathrine Murphy, the director of the Patients Association. “There needs to be a much greater political will to tackle this. Central to the Hippocratic Oath is that doctors do no harm to their patients, but lives are being lost in hospitals every day.”

As well as a thorough annual clean of ward to include walls, ceilings and air vents, new government guidelines will ban doctors’ white coats, as it is believed the long sleeves can carry infection between patients. But such moves don’t go far enough for some lobby groups.

“The uncomfortable truth is that hygiene is far more tightly regulated for slaughtermen in abattoirs than medical staff in hospitals,” say Derek Butler, the chairman of the charity MRSA Action UK. “It’s no use banning doctors’ coats when nurses can wear their uniforms home, spreading MRSA to the wider community. I believe we have a time bomb ticking away of community-acquired MRSA.”

Some hospitals already screen new patients for MRSA. Butler has called for staff to be screened, too, and taken off ward duties until the infection has been treated.

The threat from superbugs is growing; there are 18 different strains of MRSA alone, although only two are responsible for 96 per cent of deaths. As well as systematic lapses in hygiene, a preoccupation with meeting treatment targets at the expense of cleanliness has been one major factor behind the rise. Hospitals with a bed occupancy of more than 90 per cent have been found to have MRSA rates 42 per cent higher than average, and because there often aren’t the facilities for isolating affected patients, an outbreak can spread rapidly. The medical establishment is divided over whether MRSA is an airborne infection, but it can be present in dust particles, and can be transmitted through the use of shared items such as newspapers, and enter the body via wounds or where an incision has been made, for example, for a drip.

But many experts are convinced that better hygiene alone won’t combat superbugs, and there is much research going into remedies, both high-tech and traditional. Marks & Spencer has just launched Sleep Safe anti-MRSA pyjamas, containing silver thread, which kills off bacteria. A new study has shown that gels and detergents made from copper compounds possess highly effective anti-bacterial properties. A team of British scientists has come up with a virus-laden cream to be inserted into the nostrils of doctors, nurses, patients and visitors. The viruses kill off dangerous bacteria but are otherwise harmless, and the cream needs to be applied only once every three months.

The website of MRSA Action UK (http://mrsaactionuk.net) features further precautions to take when going into hospital. It advises patients to buy their own antibacterial wipes before admission and use them to wipe down all surfaces.

Estate Receives Facelift
October 31 2007

MRSA Action UK’s Hayleigh Proctor helped in an estate clean-up last week. Housing trust staff and council employees joined volunteers and got their hands dirty in a bid to clear up a Winsford estate residents feared was becoming a dumping ground.

Workers from Weaver Vale and Riverside Housing Trusts and Vale Royal Borough Council got stuck into the Impact Day along with firefighters and police officers at Greenfields Park.

Plans for the clean-up were hatched by Weaver Vale bosses after feedback from residents highlighted the growing problem of litter on the estate and their concerns over the environmental implications of the increasing volume of rubbish. The trust’s neighbourhood manager Judith Burbidge, was glad of the support shown by residents of the estate.

She said “We want to make sure the estate is clean and safe for children. We had a very successful clean-up day earlier this year and hope to build on that success. We are unable to hold days like this without support from the Greenfields Park Resident Association, the borough council and other key agencies. But most important is the resident involvement, it is vital to the days success.”

Hayleigh Proctor was amongst the school children under 11 who turned out to help were given free family tickets to this weekend’s bonfire and firework event at Verdin Park.

Vale Royal’s lead councillor for environmental management Cllr Lynn Riley, said: “We hope this initiative will help encourage people to keep their neighbourhoods clean, and I am delighted we are able to work with other partner organisations to get a scheme like this underway”.

The new superbug: GRE attacks the very ill and makes MRSA untreatable

By DANIEL MARTIN - Last updated at 01:28am on 2nd November 2007

A new superbug is on the march in Britain’s hospitals, it was revealed.

GRE attacks the most seriously ill patients - and helps MRSA to thrive in filthy surroundings. Experts fear this combination could make it the worst superbug yet - and “take over” the Health Service. GRE can cause wound infections, blood poisoning, and infections of the abdomen, pelvis, bile duct, heart valves or the urinary tract. The number of GRE infections has shot up by 50 per cent in just two years. It is more common among patients in intensive care or renal units.

The hidden danger is that the bug is also resistant to one of the few antibiotics that still works against MRSA. In the United States contact with GRE has already led MRSA to develop the same resistance, making it harder to treat.

Last night leading microbiologist Professor Hugh Pennington warned the bug could “take us over”.

Between October 2005 and September 2006, 903 people contracted the glycopeptide-resistant enterococcal (GRE) bug, according to figures released by the Health Protection Agency. This is up from 628 in 2003/04.

The antibiotic-resistant bug is particularly prevalent in hospital patients whose immune system has been suppressed, either through drugs or diseases. GRE is a form of the enterococci bacteria, which is found in the bowels. However, strains of it have formed a resistance to a type of antibiotics called glycopeptides, such as vancomycin and teicoplanin.

Dr Mark Enright of Imperial College, London, said that unless GRE was tackled, it could prompt the spread of even more virulent MRSA that are almost impossible to treat.

“GRE is very resistant to antibiotics, especially vancomycin,” he said.

“Vancomycin is the last-ditch antibiotic we use against MRSA.

“We know that at four hospitals in the U.S., vancomycin-resistant strains of MRSA have appeared through contact with GRE.

“It is crucial that MRSA doesn’t become resistant to vancomycin because then it would be almost untreatable.”

Professor Pennington of Aberdeen University said there was a danger that hospitals will be caught as unawares by GRE as they were by C. Diff. “There is a lesson there,” he said.

“Unless we nip things in the bud by taking aggressive measures sooner rather than later, this thing will take us over and cause us big, big problems.

“GRE is a problem that microbiologists are very concerned about because these bugs are certainly taking off.

“It is getting more common and it’s something that we have to take a careful note of.”

He said the Government’s target culture may be to blame for the shock rise because it means trusts are occupied with other bugs and were letting this one slip under the radar.

“It was very obvious at Maidstone and Stoke Mandeville, which both had big C. Diff outbreaks, that managers were fixated on MRSA because there were government targets there and a lot less to C. Diff because at the time there were no targets.”

While GRE is not particularly virulent, it can be difficult to treat because of limitations in the range of antibiotics that can be used against it. Two are normally used - linezolid and synercid - but some strains of GRE have been found which have developed resistance to these as well. Because people who contract GRE are usually very unwell - unlike MRSA which can target generally healthy people - it is often impossible to say whether someone died from the bug or from another cause.

The Health Protection Agency says the bug’s spread can be controlled by handwashing and cleaning all equipment after use. And certain antibiotics should be restricted to those who really needed them.

http://www.dailymail.co.uk/pages/live/articles/health/healthmain.html?in_article_id=491226&in_page_id=1774&in_page_id=1774&expand=true#StartComments

cleanyourhands enters third year with hard hitting message to all healthcare workers

18 October 2007

The Chief Medical Officer for England, Sir Liam Donaldson, today launched the third year of the National Patient Safety Agency’s cleanyourhands campaign with a clear message about the importance of hand hygiene to everyone involved in healthcare.

Sir Liam said: “It’s absolutely vital that hand hygiene is seen as a priority by every single healthcare professional - from surgeon to nursing assistant. We can’t succeed in the fight against healthcare associated infections unless we address the problem by working together as a team that encompasses the entire healthcare journey, with no weak links.

“The patient, too, has a part to play in this journey. In my Annual Report, I recommended that the cleanyourhands campaign should be further strengthened to support patient involvement, with alcohol handrub given to patients so that they can ensure that healthcare professionals clean their hands before touching them. This scheme is currently in the early pilot stages - if successful, it will offer an additional mechanism to combat infection and support safer care in the future.”

The cleanyourhands campaign aims to improve the hand hygiene of healthcare workers in order to help combat healthcare associated infections. Staff are prompted to clean their hands at the critical time and place - where and when patient care is provided.

Since the NPSA launched cleanyourhands in September 2004, independent research shows that the campaign has been effective in changing hand hygiene behaviour in acute NHS hospitals in Wales and England, with a significant rise in the use of alcohol handrub and the majority of trusts rating cleanyourhands as a top priority.

The award-winning campaign is now entering its third year with a radical new look, following consultation with frontline staff. The new campaign materials are harder-hitting, using eye-catching visuals and bold messaging to emphasise the importance of hand hygiene, with a black background giving a strong, distinctive look that stands out in a hospital environment.

Martin Fletcher, Chief Executive of the National Patient Safety Agency, said:

“Good hand hygiene is absolutely critical in the prevention of infection. We already know that cleanyourhands has made enormous headway in changing behaviour amongst healthcare workers, and we have worked with staff on how to build on that success with the launch of the campaign’s third year. They told us they wanted hard hitting materials that really highlight how serious the issue of healthcare associated infection is.

“But the campaign is about much more than just the materials. It’s about providing practical support to help healthcare organisations fight infection, and it’s also about educating, and about promoting the development of an organisational culture where individuals take personal responsibility for the delivery of safe, clean care.”

Derek Butler, Chairman of the charity MRSA Action UK, said: “Hand Hygiene should be a process of excellence that is the cornerstone of good infection prevention and control. Aristotle once said “We are what we repeatedly do. Excellence, then, is not an act but a habit.”

“Hand hygiene has to become habit forming, infection control has to be an all or nothing process; there can be no half-way house on this issue. It is our charity’s belief that there will have to be a fundamental shift in all aspects of healthcare, not least in the area of infection prevention and control”

cleanyourhands has already been adopted by all acute NHS trusts in Wales and England; it’s also being rolled out to other NHS organisations (ambulance trusts in England and Wales plus primary care, mental health and care trusts in England) and to care homes and hospices in Wales and England. Work is also underway to test the campaign in general practice.

Tackling healthcare associated infections is a worldwide issue and the NPSA supports the World Health Organisation’s Global Patient Safety Challenge: Clean Care is Safer Care. Sixty nine countries have signed up to the challenge, with 22 countries running national campaigns in healthcare. England and Wales were the first countries to launch a nationwide multimodal campaign: cleanyourhands.

Media enquiries and interview requests to Alison Pitts-Bland on 0207 927 9520.

The cleanyourhands campaign is a four year campaign which aims to improve the hand hygiene of healthcare workers and help the NHS tackle healthcare associated infections. Since its launch in 2004, the campaign has been adopted by all NHS acute trusts in England and Wales, has more than doubled the rate of hand-hygiene, and is in the process of being extended to primary care, mental health, care and ambulance trusts as well as care homes and hospices. For more information on the campaign visit http://www.npsa.nhs.uk/cleanyourhands

For further information on the independent research programme to evaluate the effectiveness of the cleanyourhands campaign in acute NHS hospitals visit http://www.idrn.org/nosec.php

The National Patient Safety Agency (NPSA) helps the NHS learn from its mistakes so that it can improve patient safety. We do this by collecting reports on errors and other things that go wrong in healthcare so that we can recognise national trends and introduce practical ways of preventing problems. We don’t investigate individual cases or complaints, but we do listen to public concerns and use what they say to improve safety.

MRSA Action UK Press Release

Embargoed until 01:00 18th October 2007

Today the Charity MRSA Action UK has the privilege to speak at the year three launch of the cleanyourhands campaign. The aim of this launch is to refocus the attention on the importance of hand-hygiene in the fight against all healthcare infections.

As a Charity we give this launch our whole-hearted support in the drive to get healthcare professionals to clean their hands between patients. Alcohol gel has improved compliance with hand-hygiene techniques and has had a role to play in reducing MRSA across many healthcare settings. We must always combine this with effective hand-washing techniques to ensure we are safe-guarding patients against cross-infection from lethal C.diff spores. MRSA Action UK believes that we cannot risk patients’ lives on this issue. Hand-hygiene should be a process of excellence, which is the cornerstone of good infection prevention and control. Aristotle once said “We are what we repeatedly do. Excellence, then, is not an act, but a habit”. Our Charity believes that this ethos should be a mind-set, that means its in your mind, set and never moves.

One death from an avoidable healthcare infection is a death too many, and in a country as advanced as ours, a scandal.

The Maidstone and Tunbridge Wells tragedy shows quite clearly the devastating effects of a complete breakdown of the management of systems in infection prevention and control. We believe as a Charity that other hospitals are teetering on the edge of similar tragedy, and both Government and the management of the National Health Service should now take stock of the events that have transpired at Maidstone and Tunbridge Wells.

When looking at the reducing numbers for MRSA bloodstream infections we must not become complacent, this is still a massive under-representation of the full picture. And if you look at the number of C.diff cases in 1996, the number for that year was 12. The figures for last year were almost 60,000 for the over 65 age-group for C.diff alone, this doesn’t include people who suffered under the age of 65 as it is not mandatory to count these, so the true scale of the problem will never be publicly realised.

The Healthcare Commission report on the outbreaks at Maidstone and Tunbridge Wells show quite clearly one of the major factors in those outbreaks was the drive to meet Government targets. It is our contention as a Charity that if we are to learn from the tragedy of this hospital, that our Government should reprioritise resources, and concentrate on the target of reducing healthcare infections in our hospitals to as low as is possible.

Today The Chief Medical Officer will be launching year three of the cleanyourhands campaign in a concerted drive to perpetuate the reductions in healthcare infections. We believe that this will have an impact on those infection rates, but is not sufficient to reduce them to the lowest level possible without being supplemented by other infection control measures. The Chief Nursing Officer has stated that infection control is a complex issue, and cannot be solved by one item alone, but will be solved by using all the measures at our disposal together.

We believe that she is correct and as a Charity we implore this Government to introduce the Dutch model of Search and Destroy in its entirety, reducing bed-occupancy, providing more isolation facilities, screening, prudent anti-biotic use and the technologies used by the Dutch to save lives.

Derek Butler, Chair MRSA Action UK

18th October 2007

Cleanyourhands campaign to tackle infection

Thursday 18th October 2007

Today Chief Medical Officer Sir Liam Donaldson launched the third year of the National Patient Safety Agency’s cleanyourhands campaign. The campaign aims to improve the hand hygiene of healthcare workers in order to combat healthcare associated infections.

Sir Donaldson said: “It’s absolutely vital that hand hygiene is seen as a priority by every single healthcare professional - from surgeon to nursing assistant.

Martin Fletcher, Christine Beasley, Derek Butler, Sir Liam Donaldson

“We can’t succeed in the fight against healthcare associated infections unless we address the problem by working together as a team that encompasses the entire healthcare journey, with no weak links.”

The third year sees the campaign launch harder-hitting, eye-catching visuals with bold messages to emphasise the importance of hand hygiene.

Sir Donaldson said that healthcare professionals wanted material that reminded them why they should wash their hands as well as when and how to carry it out.

The campaign now aims to extend its remit towards primary care, an area which Sir Donaldson said “healthcare infections still occur but is perhaps not given the same level of attention as the acute sector.”

Derek Butler, leader of charity MRSA Action UK said: “The system itself is flawed - no matter how good the processes are people cannot perform better than the organisation supporting them.”

Cleanyourhands has already been adopted by all acute NHS trusts in Wales and England and is also being rolled to primary care and mental health and care trusts.

http://www.nursinginpractice.com/default.asp?title=

Hospital bosses face possible manslaughter charges after superbug outbreak kills 90

By DANIEL MARTIN and JAMES MILLS

Last updated at 00:11am on 11th October 2007

Ninety hospital patients died in an outbreak of C difficile blamed on appalling hygiene standards.

The superbug hastened the deaths of another 180 and infected more than 1,100 in three hospitals, a damning official report says today.

Police and the Health and Safety Executive have been called in to investigate the outbreak - the UK’s worst-ever - at the Maidstone and Tunbridge Wells trust in Kent. Senior managers could face charges of criminal negligence or even corporate manslaughter.

Bereaved families described nursing care as ‘despicable’ and ‘sickening’, with patients left lying in their own excrement for hours. The report by the Healthcare Commission says a shortage of nurses meant showers and sinks were filthy and commodes not cleaned.

Chief executive Anna Walker said the trust was so obsessed with government waiting time targets and its £17million deficit that it took little action on fighting the bug, which can be eliminated with soap and water. She said: ‘This report fully exposes the reasons for that tragedy, so that the same mistakes are never made again.

‘I urge all trusts to heed the lessons of this report so they can look patients in the eye and say that everything possible is being done to protect people from infection. That is the least that patients can expect.’ The bug raged through the three hospitals between April 2004 and September 2006, The previous worst case was at Stoke Mandeville Hospital in Buckinghamshire, where 64 patients died between 2003 and 2005.

Ninety hospital patients died in an outbreak of C difficile

C. diff has overtaken MRSA as the biggest infection danger in hospitals. In 2005, the last year for which nationwide figures are available, it was cited on the death certificates of 3,807 patients. That was a sharp rise from 2,247 in 2004. but experts believe it was only the tip of an iceberg.

There had been a history of high infection rates at the Maidstone trust, which was consistently among worst 25 per cent in the country. But the board never even discussed it. A full investigation was launched only after the scale of the killer outbreak became all too clear.

Since then, patients have continued to die and last Friday Rose Gibb, chief executive of the trust, resigned from her £150,000 job.

Kent MP and former Tory minister Ann Widdecombe, who insisted last year she would not send her elderly mother to Maidstone Hospital, said last night she was ‘saddened but not surprised’ by the report’s findings. She added: ‘In recent months it had looked as if things had begun to improve, but sadly over the past couple of weeks I have received a spate of fresh complaints.’

Derek Butler, chair of MRSA Action UK, said: ‘Hygiene is a major problem across the NHS and there is no doubt that an outbreak like this will happen again, and they will occur on a regular basis until the NHS changes.

‘Chief executives and senior management have to take the rap when there are outbreaks.

‘If any of them knew there was something wrong but did nothing about it, they should be charged - and that should mean prison.’

The report says that between April 2004 and September 2006, more than 1,170 patients were infected with C. diff across the three hospitals. There were 738 at Maidstone Hospital, 353 at the Kent and Sussex Hospital in Tunbridge Wells and 85 at Pembury Hospital. In all, 345 men and women died, 90 as a direct result of the infection. It was a ‘contributory’ factor in 180 of the deaths. There were peaks in the infection toll, the first of them between October and December 2005.

But though C. diff cases had doubled the trust failed to realise what was happening, paving the way for another major outbreak between April and September 2006.

Among those who died was the mother-in-law of TV presenter Cheryl Baker, the former Bucks Fizz star and Eurovision winner. The report uncovered a series of appalling failings and shocking ignorance.

Half the trust’s doctors and nurses wrongly thought alcohol wipes could kill the bacteria. Beds were crammed into crumbling Victorian wards and only rarely left empty, making it hard to clean them. The shortage of nurses meant they were too busy to clean commodes, wash their hands or clean mattresses and equipment properly.

Even after the second outbreak, an inspection by the commission found showers and sinks were filthy, while commodes and bedpans were smeared with faeces. The report said patients were often moved between wards, increasing the risk of infection, so the trust could meet Government waiting-time targets in A&E. Doctors used too many antibiotics, allowing the bug to thrive.

The report could also open the door for relatives to sue the Kent trust. Kent police and the HSE confirmed last night they were looking into the case, which could foreshadow possible prosecutions at other hospitals. Tory health spokesman Andrew Lansley said: ‘I find this report shocking. Centrally imposed waiting list targets have become such a burden on hospital staff that they have less time and fewer resources to protect patients from the spread of C. diff.

‘The Government has broken its promise to bring down bed occupancy rates and their financial mismanagement of our NHS has meant a squeeze on nursing staff.’ Liberal Democrat Norman Lamb said: ‘This report lays out in stark terms the danger of hospital staff chasing targets when they could be concentrating on caring for patients.’

Dr Malcolm Stewart, medical director of the trust, apologised for what had happened but said C. diff rates were now lower than the NHS average. He said: ‘Rates have fallen sharply following improved isolation measures, a £1million cleaning programme, better antibiotic use and further campaigns on hand washing.’

Health Minister Ann Keen said: ‘I would like to offer my sincere condolences to the patients and families who have been affected. ‘This type of failure must not be repeated. Trusts must deliver clean, safe treatment to every patient, every time and where senior management and trust boards fail to act, they must be held accountable.’

Florrie Field was a ‘fit and active’ 86- year-old, working full-time in her daughter’s clothes shop, before she was treated at Maidstone Hospital for a minor eye infection. But she caught the Clostridium difficile superbug in March last year and died after suffering two months of severe sickness and diarrhoea.

Her daughter Brenda Charlton, 48, said conditions were ‘extremely poor’ and nurses sometimes told her mother to relieve herself in her bed as they were too busy to take her to the toilet.

Son-in-law Tony Charlton, 63, said: ‘This sort of thing should never be happening in a British hospital in this day and age. No one should have to go through the emotional turmoil that we have. I hope this report shocks people into dealing with it in the right way.’

Mrs Field’s family were told at first that she was suffering a reaction to antibiotics and she was released after two weeks. It was not until she collapsed at home that C. diff was diagnosed, but she died a few weeks later.

Another victim, Doreen Ford, had been overjoyed to be told she was winning her fight against breast cancer.

Mrs Ford, 77, the mother-in-law of Bucks Fizz star Cheryl Baker, had undergone three months of gruelling treatment after being diagnosed with the disease. But she caught the c. diff bug during one of her visits to Maidstone Hospital for chemotherapy and antibiotics failed to clear it. A day after being told her cancer was in remission, she collapsed at home. Miss Baker, 51, said: ‘We called an ambulance and I thought she’d just have antibiotics again and return home. But she passed away that evening.’

Mrs Ford, who lived with Miss Baker and Mr Stroud in Sevenoaks, Kent, was killed by septicaemia caused by C.diff. Miss Baker has since campaigned to improve hospital conditions.

Dunkirk veteran Joe Nixon went into Maidstone Hospital for a routine operation.

But the 87-year-old former Coldstream Guard was left sleeping on soiled sheets and not fed properly because nurses were too busy, his family said. He died three weeks later after contracting the superbug and pneumonia.

Mr Nixon, who was on the last stretcher ship out of Dunkirk in 1940, was so distressed during his final days that he asked his daughter: ‘What did I do that was so evil that I’m trapped in this awful place?’ His family are particularly angry because by the time he died in August the hospital was already under investigation and had pledged to raise standards His daughter Jackie, 46, of Maidstone, said she once waited almost three hours for her father’s soiled sheets to be changed and eventually did it herself.

After a confrontation with hospital managers she took him home to live the last days of his life in comfort. ‘It broke my heart to see him like that,’ she said.

http://www.dailymail.co.uk/pages/live/articles/news/news.html?in_article_id=486940&in_page_id=1770

Licensing of our new parish priest

Our new priest, the Reverend Deborah Snowball, was licensed by the Bishop of Hertford, the Right Reverend Christopher Foster on Monday 8th October in a service of joy, love and optimism.

The church was packed with members of our own congregation, members of the congregation of Great St Mary, Sawbridgeworth (Deborah’s previous parish) and many friends.

Sadly, one of the Gang of Four (aka Churchwarden John Hill) was unable to be there as he was on holiday but we promised to get the photos on the Internet as soon as possible so that he could view them from Assisi. John - you missed a great evening and we really missed you.

Deborah wrote the prayer for the victims of MRSA read for us by the Canon Robert Wright at Westminster Abbey

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