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Extra specialist staff for tackling hospital infections

DEPARTMENT OF HEALTH News Release (2008/0004) issued by The Government News Network on 9 January 2008

Health Secretary unveils new infection control strategy

Every hospital trust in England will be able to recruit two infection control nurses, two isolation nurses and an antimicrobial pharmacist with millions of pounds of extra investment for infection control in the NHS, Health Secretary Alan Johnson announced today.

New stringent requirements outlined today in the Government's strategy to tackle healthcare associated infections (HCAIs) also mean that NHS Foundation Trust applications will not be supported by the Secretary of State unless trusts are consistently hitting local targets on both MRSA and C. difficile.

'Clean, safe care' draws together current HCAI initiatives and details new areas where the NHS should invest the extra funding of £270 million per year by 2010/11 to support infection control and cleanliness in the NHS.

This funding will allow local organisations to invest up to £45m on additional specialist staff*, who play a crucial role in cleanliness and infection prevention & control.

Alan Johnson said:

"We have gone from what has been described by the HPA as 'a seemingly unstoppable rise in MRSA bloodstream infections throughout the 1990s' to a 10% fall in cases of MRSA, thanks to the hard work and dedication of NHS staff, but we know that there is still more to be done.

"The investment of an extra £270 million and this strategy will help the NHS to continue the good work going forward. Patients have my assurance that the Government will not take its foot off the pedal and will continue to do all we can to tackle infection."

From February 2008, a new nationwide campaign will be launched to remind the public, GPs and other doctors that using antibiotics is not effective on many common ailments. The campaign will also highlight that inappropriate use of antibiotics can increase the emergence of antibiotic-resistant strains of infections and that prudent prescribing is therefore required.

Alan Johnson continued:

"Healthcare associated infections are everyone's responsibility from NHS cleaning and care staff to me as Secretary of State - and I take that responsibility seriously.

"The past 60 years have seen great advances in healthcare and medicine. For example, the use of antibiotics have saved countless lives, but antibiotics do not work on most coughs, colds and sore throats and their unnecessary use can leave the body susceptible to gut infections like Clostridium difficile. The new pharmacists that trusts will be able to recruit will be key to ensuring proper antibiotic prescribing on wards."

As well as recently announced initiatives including a new 'Bare Below the Elbows' dress code and every hospital to have undergone a deep clean by March 2008, the Strategy outlines further areas that the Department is leading on to support the NHS in the fight against HCAIs. These include:

Hospitals will receive more money earmarked to tackle infection - The national tariff uplift includes a specific element to tackle infection, meaning that trusts have additional resources at their disposal Additional fines for trusts not improving infection rates - as set out in December's Operating Framework for 2008/09, the new national contract will allow PCTs to fine Trusts that are not hitting local targets on Clostridium difficile improvement. This is over and above the fines that the new Care Quality Commission will be able to place on Trusts that are in breach of the hygiene code.

Promoting innovations - a range of programmes designed to accelerate the development and uptake of new technologies

Guidance on HR procedures to be developed in conjunction with Trade Unions - including the importance of induction and training on infection prevention and control for staff

A cleaning summit held by the NHS Chief Executive - focussing on cleaners as part of the solution to infections and cleanliness and not part of the problem

Chief Nursing Officer Christine Beasley said:

"Healthcare associated infections and cleanliness in hospitals are often linked, and rightly so. We know that patients do not want to receive care in a dirty hospital. A clean environment is extremely important its own right, as well being the best platform from which to tackle HCAIs.

"Preventing infections requires a range of measures, from prudent antibiotic prescribing to implementing best practice in chronic wound management and only a comprehensive approach will succeed in driving down numbers."

Notes to editors

1. 'Clean, safe care' sets out where there are national expectations and requirements for the NHS in tackling HCAIs- but also guides NHS organisations as to the actions and investment that will be most effective in continuing to tackle infection and improve cleanliness in their local area. The document is also written with patients, public and staff in mind. It can be found at http://www.dh.gov.uk.

2. The recent Comprehensive Spending Review (CSR) set an investment of £270 million per year by 2010/11 to support continued progress in tackling HCAIs and improving cleanliness. This included £130m for the introduction of MRSA screening and a further £140m by 2010-11 to reduce C. difficile infections.

The CSR investment was reflected in a 5.5% increase in PCT allocations and the 2.3% uplift to the national tariff in 2008/09.

3. *The CSR settlement allows for local organisations to invest up to £45m on additional specialist staff. These include:

Infection control nurses: The infection control nurse is a key member of infection control teams in trusts alongside infection control doctors and medical microbiologists. Investment in this area would include training and development of existing staff as well as recruitment of new staff. Antimicrobial pharmacists: Pharmacists are extremely important in promoting good prescribing practice. Investing in pharmacy teams will allow pharmacists to work proactively with other clinical staff - such as medical microbiologists, and infectious disease specialists - and free up time to undertake other key activities such as clinical audits. Isolation nurses: Following best practice in managing patients with HCAIs will mean more isolation and cohorting of infected patients. Investment in additional nursing staff will therefore be needed to ensure that patient care is not compromised by increased isolation.

4. There are 173 Acute Trusts in England.

5. As set out in the NHS Operating Framework for 2008/09, improving cleanliness and reducing healthcare associated infections is one of the NHS's top priorities. NHS organisations will have to maintain the annual number of MRSA bloodstream infections at less than half the number in 2003/04 and by 2011 there will need to be a 30% national reduction in C. difficile infections from 2007/08 numbers.

6. Health Protection Agency (HPA) data published on 1 November 2007 showed a 10% fall in cases of MRSA in England from the previous quarter, from 1,447 between January 2007 to March 2007 to 1,303 between April 2007 and June 2007.

HPA figures for C. difficile for the quarter April to June 2007 show a reduction of 7% in the 65 and over age group compared with the same quarter in 2006.

7. Recently announced initiatives include:

Introducing screening for all elective patients by March 2009 and for all emergency patients as soon as possible over the next three years;

Annual infection control inspections of all acute Trusts by the Healthcare Commission using teams of specialist inspectors;

A new bare below the elbows dress code; and

Every hospital to have undergone a deep clean by March 2008; 5,000 matrons in place in the NHS by May 2008.

[ENDS]