A hospital that is failing to tackle superbug infections has been served with an official warning in the first case of its kind, the health watchdog will announce today.
Inspectors from the Healthcare Commission have found Chase Farm Hospital in Enfield, North London, to be in “serious breach” of the Hygiene Code, the latest government rules to manage healthcare-associated infections such as MRSA and C. difficile.
Even basic requirements, such as providing hand-washing gels at a patient’s bedside, were not in place, the watchdog said.
Barnet and Chase Farm Hospitals NHS Trust, which manages the hospital, has now been served with an improvement notice, ordering immediate changes to infection control practices. Despite reporting more than 600 superbug infections in a six-month period last year, there was “no evidence” that the trust learnt from its mistakes, the commission said.
Among “fundamental problems” highlighted during a spot-check were failures to keep wards clean, to properly assess the risks of superbug infection and to isolate infected patients so that they could not spread illness.
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The commission was given powers to issue improvement notices last year. This is its first.
The Barnet and Chase Farm Trust, which had told the commission that it was meeting the three core standards relating to the Hygiene Code, was found during an unannounced visit on June 7 to be in breach of several key duties set out in the code.
The trust was rated as “weak” in quality of services and use of resources in the 2005-06 annual health check by the Healthcare Commission. Its provision of potentially misleading information to the commission could affect its rating in this year’s assessments of NHS Trusts.
According to latest figures from the Health Protection Agency, there were 584 cases of C. difficilein patients aged over 65 at the trust from January to September last year. From April to September 2006 there were 29 reported cases of MRSA. Updated figures are expected to be published by the end of the month.
The problems, described as “wide--ranging and serious”, included:
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— A failure to provide and maintain a clean and appropriate environment for healthcare.
— A failure to provide adequate isolation facilities for patients already suffering from infections.
— A lack of appropriate management systems for infection prevention and control.
— A failure to assess risks of acquiring healthcare-associated infection and to take action to reduce or control them.
In addition, only one microbiologist, working four hours a week, was employed to monitor infections at the trust, which serves a catchment of 500,000 people. There was also no identified budget for training of staff in infection-control and attendance at such training was not monitored.
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Clinical staff were found to be “confused” about isolation policies, “indicating that they are not always adhered to”.
The commission said in a statement: “Because the trust does not conduct analysis to determine the cause of infection on all patients confirmed to have MRSA, it is difficult for the trust to monitor and learn from outbreaks and incidents.”
It has now been given deadlines to address issues raised by the commission, with the local strategic health authority overseeing the work.
Anna Walker, chief executive of the Healthcare Commission, said: “I hope this sends out a strong message to all trusts that we will not hesitate to use our powers when it comes to enforcing the Hygiene Code.”
Richard Harrison, medical director at Barnet and Chase Farm Trust, said: “Our issues around infection control follow the national picture, but with an extra £500,000 investment in cleaning the wards, screening patients before admission and our prudent antibiotic policy, the trust is winning the battle against hospital-acquired infections. The trust reported 74 new case of C. difficile in April and only 16 cases in June.”