MRSA Action UK met with the External Reference Group for the development of the new MRSA objective

21st April 2009
 
The Department of Health is developing a new goal for reductions in MRSA bacteraemia.  This is set out in the NHS Operating Framework for 2009/10, following the achievement of the 50% national target reduction.  As High Quality Care for All set out, once national targets are achieved they will become national minimum standards for all NHS organisations and a national standard for all patients.

The Department set up the External Reference group to develop ideas for the new MRSA objective, prior to a consultation later in the year.  The first meeting of the External Reference Group discussed its draft Terms of Reference and held initial discussions around the need to define how the MRSA target enters the standards framework in a way that is applicable to all NHS organisations.  The Department will draw on expertise from the NHS, Health Protection Agency, Infection Prevention and Control specialists and patient representatives.

MRSA Action UK believes the new standard should incorporate competencies for all healthcare workers that include the high impact interventions in Saving Lives.  This would be measurable across all healthcare settings, from the GP surgery, the hospital theatres and wards and in the community, applicable to anyone giving care, either in a care home setting or at home.

The new Care Quality Commission's role will be pivotal in monitoring and supporting organisations through this process of driving excellence in healthcare.

We believe patient care would improve considerably if the same focus and attention was given to surgical site infections and urinary catheter infections which cause considerable morbidity and mortality, the MRSA bacteraemia target focussed hearts and minds and should be extended in the drive towards no avoidable infections.

The goal set has to be clear and unambiguous and in a form that is easy to understand, we would prefer to see numbers of infections by individual hospitals published with a percentage ratio that we believe is more meaningful to members of the public than the ratio to bed days.

The NHS is also expected to reduce Clostridium difficile infections by 30% by 2010/11.  It is worth noting that whatever objective is developed for MRSA bacteraemia, it is likely that the same type of objective will also apply in the future to Clostridium difficile, so the work on MRSA will need to take the potential consequences for Clostridium difficile into account.  Commissioners can take action to ensure high-quality care for patients, such as fining providers who are not making the required improvements on Clostridium difficile infections.  Information on infection rates for individual trusts are not consistently reducing, and we believe the 30% reduction is not challenging, the tougher the target the more likely Trust Boards will ensure that resources are directed at reducing to as near as zero as possible.  We need to ensure a greater focus on Clostridium difficile, particularly where Trusts are not reducing infections.

MRSA Action UK look forward to working with the Department of Health.