Derek Butler, Chair
Email: derek.butler@mrsaactionuk.net
Telephone: 07762 741114 Archived articles
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Above All, Do No Harm!
MRSA Action UK's response to the Health Committee Report on Patient Safety
3rd July 2009
MRSA Action UK may be mistaken, but are the Health Committee's findings the understatement of the year. The opening line "Improve patient safety data, banish blame culture, and build on decade of policy initiatives to reduce patient harm"
"Primum Non Nocere" may not have been written by Hippocrates, however "Above All, Do No Harm" should be the mantra of any healthcare professional and, we would have hoped, the Health Committee.
The Health Committee studied written and oral evidence, looked at regulation and concluded that it was necessary to "build on a decade of policy initiatives to reduce patient harm."
Our Charity submitted written evidence, however there was no call to hear the patient and relative perspective from those who had succumbed to largely avoidable infections, leading to death and varying degrees of disability. The patient's voice appeared largely unheard.
In our submission we cited The Joint Commission in the
The report lacks any mention of such a system to protect whistleblowers, our own reporting systems via the National Patient Safety Agency fall far short of the Joint Commission in the
In terms of monitoring healthcare infections, hospitals who have significantly reduced the recorded numbers of patients with infections have demonstrated a change in culture and mindset, recognising that avoidable infections and medical harm will not be tolerated.
This has been achieved through strong leadership from Board to Ward. However, this data on hospitals with larger numbers of infections or standardised mortality rates seems largely ignored by regulators who can act swiftly to bring about change.
We are still seeing hospital trusts with significantly larger numbers of avoidable infections each quarter, yet there has been no change in management, something the regulator can take action on.
Data on patient safety, including healthcare infections should be used as a double-check to make sure resources are targeted in the right way. Above all healthcare professionals should engage with patients and relatives and remember that they are people, not cases. Our own data on patient involvement in care shows a significant lack of dialogue with both the patient and relatives who are primary carers, the very people who can recognise signs of deterioration quickly.
We have already called for a review of case notes where relatives know that healthcare infections were a contributory factor in their loved-ones deaths. Using data is important to check that there are no worrying trends in the numbers of people who may have succumbed to avoidable bloodstream infections, if you don't measure then how can you be sure you have done everything possible to reduce harm?
The roles of Monitor, the Care Quality Commission and the Strategic Health Authorities should be to make sure resources are targeted effectively, be that in terms of funding, training, safe clean environments and using the best technologies to ensure top quality safe care. Using top-line data such as standardised mortality rates, healthcare infection surveillance and reviewing case notes and complaints should be an integral part of checking policies are working.
Derek Butler
Chair
MRSA Action
07762 741114
MRSA screening bill pushed in Congress
Wednesday, June 24, 2009
New legislation recently introduced in Congress would help to significantly reduce the incidence of an antibiotic-resistant, hospital acquired infection that kills nearly 19,000 Americans every year.
HR 2937, introduced by Representative Jackie Speier (CA), would require hospitals to screen patients to identify those who are carriers of Methicillin-resistant Staphylococcus aureus (MRSA) bacteria as part of a strategy aimed at preventing the spread of MRSA infections to other patients. The bill requires hospitals to disclose MRSA infection rates to the public and encourages hospitals to follow other measures to improve patient safety. A similar measure (S. 1305) has been introduced in the Senate by Senator Robert Menendez (NJ).
The bill seeks to enact nationally what advocates such as Jeanine Thomas have achieved in 32 states, and requires:
- hospitals to screen all patients entering high-risk units for MRSA infection
- adoption of best practices including contact precautions among health care professionals to prevent MRSA?s spread within hospitals
- patients testing positive for MRSA be informed of the result and given instructions on how to prevent the spread of their infection when discharged.
- hospitals to report the number of cases of hospital-acquired MRSA that occur within their facilities.
To track progress click here
World MRSA Day Momentum Builds In The US And The UK
23 Jun 2009
MRSA Survivors Network, the Chicago-based nonprofit and the official organization that launched World MRSA Day earlier this year is building momentum in the US, the UK and worldwide in its humanitarian grass-roots effort to raise awareness of the MRSA epidemic.
"As governments and world agencies continue to put their focus on swine flu and prepare to spend billions of dollars on it as they did with Avian flu; the true epidemic/pandemic, MRSA continues to be virtually ignored", states Jeanine Thomas, president of MRSA Survivors Network and the National Spokesperson for MRSA. "It is unconscionable what has been allowed to happen and MRSA has been swept under the carpet in healthcare facilities for decades and the purpose of World MRSA Day is to raise awareness."
Healthcare industry companies are stepping up and sponsoring World MRSA Day in the
The inaugural pre-launch kick-off event in the
MRSA Survivors Network and fellow activists are pushing for immediate action, legislation, funding, more stringent and pro-active infection control measures and enforcement by the World Health Organization, the Centers for Disease Control and governments to stop the massive loss of life and human suffering from preventable infections. World MRSA Day is embracing all survivors and their families who have suffered or lost a loved one from any multi-drug resistant infection.
Jeanine Thomas of MRSA Survivors Network was the first advocate in the
Source
MRSA Survivors Network
Article URL: http://www.medicalnewstoday.com/articles/154878.php
Superbug cases slashed by a third - but one in 12 patients still contracts an infection in hospital
By Jenny Hope
Last updated at 5:54 PM on 18th June 2009
Hospitals have met their target of a 30 per cent cut in patients affected by the potentially deadly C. diff bug.
But the new figures come as cases have started creeping up again, along with a small rise in MRSA infections.
Health Secretary Andy Burnham welcomed the figures, saying the NHS had hit its target of cutting C. diff infections two years ahead of schedule.
New figures have revealed that hospitals have successfully slashed superbug cases by a third - but one in 12 still contracts an infection
But critics claimed efforts to eradicate the bugs had reached a plateau and a new drive was needed to tackle these and other health-care associated infections.
One in 12 patients contracts an infection while in hospital in
Latest figures from the Health Protection Agency for January to March in
This was a 36 per cent reduction over the same period last year, when 12,967 cases were reported, but a six per cent increase in the 7,908 cases reported from October to December 2008.
Over the first three months of 2009, there were 692 bloodstream infections of MRSA which was a cut of 29 per cent over the same quarter last year.
But it was a two per cent rise compared to the three month period October to December 2008, when 678 cases were reported.
In the financial year April 2008 to March 2009, 2,932 cases of MRSA were reported - a 34 per cent cut compared with the previous year.
Professor Mike Catchpole, deputy director of the HPA's Centre for Infections said: 'The substantial drop we have seen in MRSA bloodstream infections and C. difficile over the past year is impressive and a credit to the hard work of our colleagues in the NHS, strengthening good practice in infection control.
'Although very small, there have been increases in MRSA cases and C. difficile cases from the previous quarter but we have observed these before, within an overall annual fall, particularly in the first quarter of the calendar year.
Health secretary Andy Burnham welcomed the figures - but critics said the Government needed a new drive to tackle the issue
'If we are to continue to see reductions in healthcare associated infections it is vital that the measures which have won this significant success remain in place and that the public and healthcare workers recognise their importance.'
Mr Burnham said: 'I am exceptionally proud of the NHS staff who have truly risen to the tough challenge we set them to substantially reduce healthcare associated infections.
'Because of their tireless hard work the target to reduce C. difficile infections by 30 per cent has today been met and exceeded with numbers down by 36 per cent - two years ahead of schedule.'
However, Derek Butler, chairman of campaign group MRSA Action said the Government was relying on major reductions in infections at a few hospitals to make the overall picture look good.
It masked a postcode lottery with some hospitals making virtually no headway, he said.
During the last quarter one-third of trusts had a rise in MRSA cases, with 18 per cent standing still, so less than half had made real improvements.
'It's worrying because we seem to have reached a plateau where hand hygiene and general cleanliness fail to make any further impact. We need a fundamental change in approach,' he added.
Shadow Health Secretary, Andrew Lansley, said 'Patients will be extremely worried that MRSA and C diff infections have started to increase again.
'It is extraordinary that on the day we find out that these deadly infections are on the rise that the new Health Secretary Andy Burnham has boasted that he is "proud" of Labour's record.
'These figures expose Labour's complacency and their failure to tackle this blight on our hospitals.
'Just last week the National Audit Office said that almost a quarter of hospitals still do not have the facilities to isolate patients with an infection to stop it spreading. Instead of taking real action Labour have pursued gimmicks like Gordon Brown's flawed deep-cleaning programme.
'A Conservative Government would take a zero tolerance approach to hospital infections. We are committed to doubling the number of single rooms in NHS hospitals so that all patients who need to be isolated can be.'
Dr Peter Carter, Royal College of Nursing chief executive and general secretary, said: 'The leadership and innovation of nurses has been central to driving down infection rates, and improving the quality of care for all patients.
'However, these figures do show that while the general trend is a reduction in infections, the increase last winter demonstrates that challenges remain.'
Government guilty of taking their eye off the ball on hospital bugs
12 June 2009
The National Audit Office report into progress in tackling healthcare associated infections has revealed what the National Charity MRSA Action UK has been saying for months.
Despite the great efforts being made in many NHS Acute settings there is still a long way to go before we can say the endemic spread of healthcare associated infections has been quelled.
The postcode lottery remains and many hospitals are seeing dramatic increases in deadly infections. In April we reported that 22 Acute hospital areas were seeing a rise in infections, and worryingly this was happening outside of the Acute hospital setting.
MRSA Action UK fears that with cuts to budgets in community hospitals where investment is badly needed this worrying trend may well continue. We know that technology is now contributing to reducing infections, the Design Bugs Out programme was welcomed by patient groups and hospitals, sadly without investment being made across the healthcare setting we will continue to see people moving between care settings being exposed to environments that are not conducive to reducing infections. The estimated saving of between 141 million and 263 million pounds made by reducing infections nationally must be reinvested in preventing further infections across the board.
Hand washing remains a challenge for some, with patients observing doctors in particular not following guidance on bare-below-the elbow and not adhering to key moments for hand hygiene. Poor recording of antibiotic prescribing and resistance in hospitals is also a significant concern, we are much better at it in the community setting and hospitals should learn from their peers.
Our campaign to record and publish more than the MRSA bloodstream infections is backed by the National Audit Office findings. There are indeed many infections that go largely unreported and unmeasured. You cannot reduce infections if you are not measuring infections, you cannot measure infections if you are not recording therefore you cannot improve performance. Surgical site infections, urinary tract and catheter infections account for significant number of people who become ill with infections and sadly die. These drop below the radar in the government figures and should be published. MSSA also contributes significantly to the burden on the system and the suffering it causes to patients. Methicillin resistant strains have not actually displaced methicillin susceptible strains: all they done is add considerably to the burden of disease.
We have asked that the Department of Health consider stepped targets for hospitals who are not improving at the same rate as the top performers, so that the focus can be put onto bringing about the culture change needed to drive a zero tolerance ethos into the failing hospital trusts.
Whilst the "can do attitude" is one of the biggest factors in driving improvement, it cannot be done unless staff are well resourced, both in terms of investment in the environment and staff numbers, but also in terms of the skills needed.
With greater powers than its predecessors, the Care Quality Commission has a major role in helping to maintain the drive to reduce infections. Our charity's hope is that the regulator will work with the poor performing trusts. Where trusts fail to maintain year on year reductions the Care Quality Commission must use swift enforcement. This should not disrupt services to patients; if Boards and Senior Executives are culpable then they should be replaced by those who are competent.
Monitor must make better use of patients' views and ensure that Foundation Trusts are truly engaging with their local communities to avoid future tragedies such as the deaths and suffering at Mid Staffordshire NHS Foundation Trust.
The Department of Health's Cleaner Hospital Programme has listened to our concerns and Improvement Teams are working with poorer performing trusts to drive improvements in infection rates. The policy makers and the regulators must continue to work together for the benefit of patients.
This really is an "all or nothing affair" and everyone should have access to clean, safe care, wherever they live, the postcode lottery must end.
Derek Butler
Chair
MRSA Action
Registered Charity No.1115672
07762 741114
in Hospitals in
12 June 2009
A new report claims the government is not doing enough to combat deadly hospital bugs, with some infections reportedly soaring
The Government has spent 120m pounds since 2004 to combat super bugs
Despite an overall reduction across the NHS following a 120m pounds crackdown, MRSA and Clostridium Difficile have increased in some areas.
One-in-10 NHS trusts has seen a rise in MRSA cases and Clostridium difficile is up in one-in-five.
The National Audit Office is also concerned bloodstream infections, such as MSSA, which actress Leslie Ash contracted, may be on the rise.
The Department of Health has met its target to reduce MRSA by 57% but not all trusts are complying with government guidelines.
Amyas Morse, head of the National Audit Office, said: "With a focused centrally-driven initiative of this kind, the improvements are not uniform across the NHS."
Actress Leslie Ash contracted MSSA
Morse claims the key problems that need to be addressed are "a lack of robust comparable data on other infection risks; increases in antibiotic resistance and poor data on hospital prescribing".
Chair of the Committee of Public Accounts, Edward Leigh MP, said the increases are "threatening all those who use our healthcare system".
Around 9,000 people died in 2007, when either MRSA or C Diff was a factor involved in their deaths.
Derek Butler, the Chair of MRSA Action UK, told Sky News Online that the Government need to "up their game" when it comes to superbugs.
"The NHS needs to stop using 19th century practices to combat this problem. They need to think beyond hand cleanliness and start using more modern methods to be more effective at reducing these bugs." Butler said.
"The benefit of reducing superbugs is that anti-biotic stocks with last longer." Derek Butler claims.
"Pharmaceutical companies are not developing them quick enough because it costs too much and the Government needs to step in and help companies in their development."
(c) Sky News 12 June 2009
Dad makes it curtains for killer hospital bug
22 April 2009
A BUSINESSMAN who caught MRSA while in hospital has won a prestigious award for inventing a device which prevents the infection. Father-of-five Peter Gardner, 61, of Jackass Lane
Mr Gardener caught MRSA while in Guy's and St Thomas ' hospital in London St Thomas
He bought a factory in China in 2006 and now supplies, among others, Queen Mary's Hospital, in Sidcup, and Dartford's Livingstone Hospital
Maidstone and Tunbridge Wells NHS Trust, which had the worst outbreak of the superbug C-Diff in which 90 people died between 2002 and 2006, was one of the first to start using the curtains. It now claims to have one of the lowest infection rates in the country.
Mr Gardner said: "It's amazing really. Cynics say we're making money out of illness but if it saves lives it has to be a good thing."
The curtains, nearly 10 times cheaper than normal hospital ones, are made of a special material that kills MRSA, as well as being fireproof and waterproof.
Mr Gardner was previously the managing director of two other companies and chairman of trade associations, but views his latest award as the pinnacle of his business career. He said: "This is the best thing I have ever done. I've been working all my life to prove I can develop things and make things work. But nothing is more satisfying than winning this award. I'm absolutely made up as they say. It was something I really really wanted. I was a secondary modern lad who left school with no qualifications. If I can do it, anybody can. It's not about qualification, it's about dedication."
Mr Gardner will be invited to a reception at Buckingham Palace
Nurses' uniforms pose superbug risk
SARAH BREALEY, ADAM GRETTON
Stricter superbug controls were demanded last night after it emerged that Norfolk's main hospitals were still allowing nurses to wear their uniforms outside work.
Health chiefs spoke of their concern that the county's acute hospitals are putting patients at risk of potentially life-threatening illnesses by not forcing staff to change their clothing after a shift.
The increased demand on beds has also raised fears about a future rise in healthcare-acquired infections - despite a dramatic cut in MRSA and C difficile rates in Norfolk and Waveney over the last year.
The Norfolk and Norwich University Hospital yesterday announced a drop of more than 50pc in MRSA and C-diff cases.
But members of Norfolk's health scrutiny panel have raised concerns about the number of hospital staff wearing uniforms outside of work and high bed occupancy rates.
MRSA Action UK called on the government earlier this year to make it compulsory for nurses to change out of their uniforms after finishing work to help stamp out the deadly infections. But the Department of Health has left it to individual NHS trusts to decide their own uniform policy.
Officials from Norfolk's three acute hospitals currently allow nurses to wear uniforms when travelling to and from work, but encourage them to wear a long coat over their work clothes and urge them not to go shopping in their uniforms.
It has also emerged that the James Paget University Hospital at Gorleston and some community hospitals do not even have a place for staff to store uniforms.
Judy Ames, lead infection control nurse at NHS Norfolk, said she shared people's concerns about staff wearing uniforms outside work, including N&N staff wearing them on the bus.
She said: "I do get frustrated when I see nurses in uniform in commercial premises. If you see it, I would say report it."
Jonathan Williams, assistant director of health intelligence at NHS Norfolk, said there was no conclusive evidence to suggest banning staff from wearing a uniform outside of work would limit the spread of infection.
"Ideally we would encourage staff to change into their uniforms at work but appreciate this is not always possible where space for changing, storage and laundry facilities is limited," he said.
Derek Butler, chairman of MRSA Action UK, said the government advice for patients with MRSA was to change their clothing daily but there was conflicting advice for hospital staff.
"We are not satisfied that every effort is being made to ensure patient safety with regard to the lax policy on the wearing of uniforms in the public domain," he said.
But Andrew Stronach, for the Norfolk and Norwich University Hospital, said some of the foundation trust's staff worked in the community and had to wear their uniforms in public.
"Our infection rates are the lowest in the county and nurses wearing uniforms in public are not a huge risk. From a microbiological view, there is not a huge body of evidence to say uniforms are a huge source of transmission. Hand hygiene is the key," he said.
Noel Scanlon, chief nurse and chief executive of the Queen Elizabeth Hospital, King's Lynn, said: "The public perception is that it is not acceptable to see someone wearing a nurse's uniform outside work. Our policy is strongly to discourage nurses from wearing uniform outside the premises and they should not enter shops and commercial premises with their uniform on."
At the Norfolk and Norwich University Hospital, there were 15 cases of MRSA and 139 cases of C difficile in 2008-9 - a record low and down from 33 and 326 the year before.
At the QEH, there were 8 cases of MRSA - the same as the year before - and 98 of C diff - down from 227 the year before.
The JPH recorded 10 cases of MRSA and 90-100 of C diff, down from 31 and 154.
A Department of Health spokesman said: "It is the responsibility of each NHS Trust to have its own policy about the wearing of uniforms. Trusts are expected to keep their policies in respect of uniforms and workwear under review."
Dr Foster on ITV'S Tonight Programme "How safe is your hospital?"
April 08, 2009 Healthcare & Hospitals News
(PRLEAP.COM) April 8, 2009 - ITV's Tonight Programme has revealed that Dr Foster was first to warn about failings at the Mid-Staffordshire Hospital Trust where more patients than would be expected had died unnecessarily.
Watch How Safe Is Your Hospital? here: http://www.itv.com/News/tonight/episodes/Howsafeisyourhospital/default.html
How Safe Is Your Hospital?, which aired March 30 2009 at 8pm, also revealed that the Dr Foster Unit at Imperial College had flagged a warning with the Healthcare Commission in July 2007 and again a month later.
The Dr Foster analysis had identified that the Mid-Staffordshire Hospital Trust had the fourth highest Hospital Standardised Mortality Ratio (HSMR) in England for the three-year period 2003 to 2006.
The Healthcare Commission eventually launched a full investigation and a report into failings at the Trust.
Access the Healthcare Commission report here
The Tonight Programme criticised the Healthcare Commission for not acting sooner despite warnings.
Other media coverage has also highlighted how the early warnings provided by the Dr Foster Unit and Dr Foster's 2007 Hospital Guide were not acted upon quickly enough by the Healthcare Commission.
The Dr Foster Unit develops pioneering methodologies that enable fast and accurate identification of potential problems in clinical performance, as well as areas of high achievement.
The Dr Foster Unit was established in 2000 within the Division of Epidemiology, Public Health and Primary Care, part of the Faculty of Medicine at Imperial College in London.
Dr Foster also produces consumer guides to health services, the first of which was published in 2001 - The Hospital Guide.
The publication of the Hospital Guide marked the first ever instance that comparative adjusted death rates for all NHS hospital trusts had ever been made public in the UK.
Dr Foster information tools are used by over 70 per cent of the NHS and comparative information for the public is now also published on Dr Foster's consumer-facing website: www.drfosterhealth.co.uk.
Tim Kelsey, Chair of the Executive Board of Dr Foster Intelligence, stated, "The NHS is now one of the most closely monitored health economies in the world and the alert that triggered the Mid Staffordshire investigation is evidence that this new system is working and that the NHS is beginning to use information and data effectively."
Roger Taylor, Research Director of Dr Foster Intelligence, added: "While mortality rates should never be looked at in isolation, they can provide powerful evidence of where care may be failing. Dr Foster believes this information should be in the public domain and taken seriously by hospitals. In the case of Mid-Staffs, Dr Foster's published analyses in the Hospital Guide 2007 had raised cause for concern for some years prior to the investigation by the Healthcare Commission."
Derek Butler, the chairman of MRSA Action UK, said: "The [Dr Foster] data which is freely available and in the public domain should be used as a management tool, not only by the Hospital Trust Boards and managers, but also by the regulators."
You can access Dr Foster's Hospital Guide to find out how your local hospital performs against other hospitals in England.
Find out more about Dr Foster's Real-Time Monitor tool on the Dr Foster corporate site.
Editors' Notes
1. HSMRs: Dr Foster publishes HSMRs as one of a basket of quality indicators in its annual Hospital Guide and over www.drfosterhealth.co.uk. Dr Foster has always advised that HSMRs should not be used in isolation in evaluating the quality of a hospital.
2. About Dr Foster: Dr Foster is the UK's market-leading provider of information, analysis and targeted communications to health and social care organisations. An independent organisation, Dr Foster Intelligence was launched in 2006 as a joint venture between Dr Foster Ltd and the NHS Information Centre for health and social care. Dr Foster Intelligence aims to set a new standard in information for health and social care providers and their users and is legally required to follow a code of conduct that prohibits political bias and requires it to act in the public interest. The Dr Foster Ethics Committee is an independent body empowered to adjudicate on complaints and oversee the code of conduct.
3. About Dr Foster Health: Dr Foster Health is the leading innovator in benchmarking public services and communicating information about services to the public. We produce authoritative and independent guides to health services in the public and private sectors. Our aim is not only to inform, but also to act as a catalyst for change.
Contact Information
Alex Young
Dr Foster Health
0044 207 8906
Email Dr Foster Health
Hospitals failing infection standards
Fri 3rd Apr 2009
Twenty-one trusts have failed to meet the infection control standards, the new healthcare 'super-regulator' has said.
The Care Quality Commission found that ten acute hospital trusts, six primary care trusts, four mental healthcare trusts and one ambulance trust failed to meet government-set hygiene targets.
All trusts were told that they had to meet the government standards for cleanliness to register with the CQC.
They have now been given a deadline by which to improve their standards of hygiene. Those that fail to do so will face "tough" sanctions from the new regulator.
Cynthia Bower, chief executive of the CQC, told the BBC that, overall, the figures represent a "statement of success" for the NHS.
She said that 388 trusts "demonstrated that they have met this standard which is about protecting patients from the risk of infection".
And Bower explained that the new regulations were designed to "put pressure" on trusts.
"It is asking them to demonstrate that they are doing everything that they can," she said.
"Where we think trusts can be doing more, we have given them a deadline to complete additional action.
"If they don't comply, we can take legal action against them."
She added: "In the most extreme cases, we could take their registration away."
But Derek Butler, chairman of MRSA Action UK, said he was "not entirely" satisfied with the CQC's analysis.
He told the BBC: "I am very happy that all the regulators have now come under one roof.
"But I will consider whether it is a 'super-regulator' in 12 months time when I see what they do with the hospital trusts that have clearly breached this hygiene code for the last two years.
"Let me just clarify that. [The target] is not something that has just come into power. It has been in power since 2006. And they are still breaching it.
"Some hospitals infection rates have actually risen in the last three months. And they are not tackling these infections."
But a Department of Health spokesman said the small number of trusts that had conditions placed on their registration have already started working on improvement plans with the CQC.
"We expect those trusts to rapidly improve the safety of the services provided and deliver a high quality of care as expected by all patients," he said. 
