Department of Health and Social Care
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MRSA infections cut by more than half
Health Secretary Alan Johnson has paid tribute to NHS staff for their significant success in going beyond the Government's target of halving MRSA blood stream infections across England.
The latest quarterly figures on MRSA bloodstream infections, published by the Health Protection Agency today, show that the number of MRSA infections has fallen by 57% compared to the base level in 2003/4 when the target was set.
The figures show that the risk of becoming infected with an MRSA bacteraemia is at its lowest for 5 years. This has been achieved by a package of measures including higher standards of clinical practice and cleanliness, an increase in matrons and hospital deep cleans.
Alan Johnson said;
"Our strategy for tackling infection is clearly delivering results and the NHS continues to work hard to ensure hospitals are clean and safe for patients. But we are certainly not complacent and we won't stop here. Healthcare associated infections present a huge challenge to health services across the world and we will continue to do all we can to tackle them.
"Hand hygiene, high standards of cleanliness, bare below the elbows, deep clean of hospitals and screening patients for MRSA are all vital elements of our strategy, so too is sensible use of antibiotics. But now we are stepping up a level and looking increasingly towards technology and design to play its part in the fight against infection which is why I am delighted to be launching the 'Showcase Hospital' scheme.
"There were those who said our MRSA target was completely unachievable and it was certainly very challenging. But it is the tremendous efforts of NHS staff that has achieved this significant reduction, resulting in real improvements to patient care."
Alan Johnson spoke whilst meeting infection control nurses and other staff at one of the new 'Showcase Hospitals', Imperial College Healthcare NHS Trust in London. Run by the NHS Purchasing and Supply Agency, the Showcase Hospitals scheme consists of seven hospitals that will trial new and innovative products to further reduce and prevent healthcare associated infections.
The seven new showcase hospitals are just one way that will enable the NHS to sustain the reduction in MRSA infections. The NHS Purchasing and Supply Agency are also launching the Design Bugs Out project. Top designers have been challenged to design new furniture, equipment and services for hospital wards that will enhance cleanliness and help to reduce healthcare associated infections.
Paul Cryer, Programme Manager of the HCAI Technology Innovation Programme, which runs the Showcase Hospitals said;
"We know that the basic ways of preventing and reducing HCAIs are largely unchanging, with measures such as remorseless hand washing making a huge difference. But new technologies and equipment can help us tackle things better and so help to reduce HCAIs more quickly.
"The HCAI Technology Innovation Programme, funded by the Department of Health, aims to speed up the development and introduction of technologies to help combat infections and improve cleanliness."
The Government will now work with the NHS to sustain this reduction in MRSA infections, as well as delivering a 30% reduction in C. difficile in the next three years. The Department of Health is investing £270 million per year by 2010/11 in improving infection prevention and control - this includes stringent hand-washing guidance for the NHS, clear guidance on appropriate antibiotic prescribing and the clinical care of patients with healthcare associated infections.
NOTES TO EDITORS
1. The national MRSA target was announced by John Reid, the then Secretary of State, in November 2004. To meet the target the NHS had to halve the number of MRSA blood stream infections. The baseline for the target is the quarterly average for the year 2003/4 - this was 1,925. The NHS had until the end of March 2008 to reach this target. Success was measured by looking at the quarter following the deadline (ie April - June 08). To meet the target the NHS had to reduce the number of cases to less than 963. The latest HPA figures for this quarter show the number of cases has dropped to 836. This represents a reduction of 57%.
2. The MRSA target is measured against data from this quarter (Apr-Jun 08). We have looked at data for a complete quarter following the target deadline to see whether the NHS has been able to sustain the 50% reduction. The MRSA target is being measured in line with other national NHS targets (eg A&E), which also measure the period immediately after the deadline.
3. As part of the £270m CSR investment, £45m was identified for investment in additional staff. It is for local organisations to decide the best investment to meet their needs, but this level of funding could, for example in each acute trust, two infection control nurses, one pharmacist and two nurses to care for patients in isolation, alongside additional infection control nurses in every community.
4. We have in place a comprehensive strategy to tackle healthcare associated infection. This includes:
* The number of matrons on our wards has increased to more than 5,000.
* We have issued best practice guidance to the NHS on antibiotic prescribing, isolating patients and clinical techniques to minimise the risk of infection along the patient journey.
* There are additional staff for the NHS such as infection control nurses, antimicrobial pharmacists and nurses to care for patients in isolation
* £50m has been made available to SHA Directors of Nursing in 2007/08 and the CSR funding settlement includes £270m per year by 2010/11 to tackle HCAIs
* A new bare below the elbows dress code has been introduced to support the successful hand hygiene campaign
* We have improved cleanliness across the NHS. As of May 2008, 328 trusts have completed their deep clean programmes. Following completion of this national deep clean programme, DH is working with SHAs to disseminate learning and best practice to the local NHS to enable them to determine the ongoing requirements for deep cleaning.
* Bespoke support to Trusts supplied by Department of Health Improvement Team.
5. Seven Showcase Hospitals across England are testing new infection beating products as part of the Showcase Hospitals scheme led by NHS PASA. NHS PASA will then work with hospitals to make the successful products widely available across the NHS as quickly as possible.
The Showcase Hospitals Programme is part of the wider HCAI Technology Programme which aims to:
- help identify the kinds of technology that the NHS needs;
- show how certain technologies add more clinical value at the front-line;
- get more value per NHS £ spent on HCAI related technologies;
- let the NHS better understand the broader evidence about how and why some technologies are better than others.
The HCAI Technology Programme has been designed to accelerate the development and adoption of new technologies into the NHS to help fight infection. The Showcase Hospital component of the programme takes technologies that have demonstrated they help reduce infection and places them into 7 hospitals around the country to evaluate how they work in practice and allow doctors and nurses to see what they can do at first hand.
6. The technologies currently being tested are:
* Bardex IC - Bard - silver alloy coated hydrogel catheters.
These use silver to reduce bacteria that cause urinary tract infections
* ChloraPrep - Enturia Ltd.
Used for skin disinfection before skin is punctured.
Hydrogen Peroxide Vapour System - BIOQUELL
Highly effective in decontaminating enclosed rooms/units.
* Flexi-Seal (faecal management system) - ConvaTec.
A tube and collecting bag system for patients with severe diarrhoea.
* Zassi (bowel management system) - Hollister.
Similar in principle to Flexi-Seal but includes a facility to dose antibiotics directly into the bowel.
* Clean-Trace Hygiene Monitoring System - 3M
A testing system which can detect in seconds whether surfaces and equipment are sufficiently clean.
7. The seven Showcase Hospitals are;
* Calderdale and Huddersfield NHS Foundation Trust
* Central Manchester Children's University Hospitals NHS Trust
* County Durham and Darlington NHS Foundation Trust
* Imperial College Healthcare NHS Trust
* The Lewisham Hospital NHS Trust
* The Royal Wolverhampton Hospitals NHS Trust
* Southampton University Hospitals NHS Trust
8. More information can be found at; http://www.clean-safe-care.nhs.uk
9. NHS Purchasing and Supply Agency, an executive agency of the Department of Health, works to ensure that the NHS in England makes the most effective use of its resources by getting the best possible value for money when purchasing goods and services - http://www.pasa.nhs.uk.
10. The Design Council has been commissioned to engage with some of the most talented designers to develop and manage the 'Design Bugs Out' programme. This will involve creating 10 better designs for critical hospital equipment and furniture which have historically proved hard to clean effectively and where redesign will not only make them easier to clean but where we can incorporate new modern easy-clean. These 10 new designs will be available by March next year.
