Hospital managers forced into 'life and death' choices

Hospital managers are being forced to make life or death decisions about closing wards when faced with an infection outbreak, according to the body that represents NHS trusts.

The lack of single side rooms in many older hospitals means that when one person contracts a bug such as C.difficile, managers must close an entire ward and cancel dozens of operations, or try to manage the infection alongside other, uninfected patients.

Dr Gill Morgan, chief executive of the NHS Confederation, defended trust managers, saying they were often placed in an impossible position.

She said: "The people who make these decisions are not just men in grey suits but doctors and nurses and other clinical experts as well. They can often face an incredibly complex situation and set of decisions.

"British hospitals do not have as many side rooms as other European countries, so when you get an infected patient, do you close an entire ward, which can mean cancelling lots of operations, delaying other patients' treatment and potentially cost lives, or do you try to work with the slightly higher risk of infection and keep the ward open?

"The hospitals being built now do have more side rooms and in the long term, that will help, but it is going to take a long time ... to get up to that level.

Ms Morgan also warned against ministers imposing too many edicts on managing infections such as C.difficile and methicillin-resistant Staphylococcus aureus (MRSA), insisting that trusts needed the freedom to make decisions about managing superbugs. She said: "The decision [about closures] can depend on the ward and the trust and the nature of the infection, and we need to leave that to the experts and the clinicians."

The NHS Confederation will discuss the issue of hospital acquired infections at its national conference in Birmingham this week. Sarah Mullally, the Government's chief nursing officer, will speak on Friday on how to reduce levels.

The Government faces increasing pressure to bring the problem under control, with patients now more concerned about contracting an infection than about the risks of surgery.