Pressure to hit targets linked to rise in cases at superbug hospital

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Doctors at a hospital stricken by the outbreak of a lethal infection repeatedly protested to management that the care of patients was unsafe.

Doctors at a hospital stricken by the outbreak of a lethal infection repeatedly protested to management that the care of patients was unsafe.

Documents leaked to The Independent reveal growing concern among medical staff at Stoke Mandeville that patients with infections were being inappropriately admitted to wards without isolation rooms or adequate facilities because of pressure to reach government targets.

The hospital was hit by a virulent new strain of Clostridium difficile in late 2003 that infected 300 patients and caused 12 deaths. Attempts to eradicate it failed, and this week Patricia Hewitt, the Secretary of State for Health, said she would order an inquiry after the outbreak was under control. Ms Hewitt added: "I expect NHS Trust leadership to focus on hospital infections. This is something chairmen and chief executives have to take personal responsibility for."

The number of C. difficile cases at Stoke Mandeville peaked in March 2004, and again in February this year. On Tuesday, the hospital said the number of cases had declined since February, with 21 in-patients now infected and seven new cases in June.

Minutes of medical staff committee meetings at Stoke Mandeville show doctors were worried that unsafe practices were spreading the infection more than a year after the outbreak began. On 17 March 2005, doctors discussed the "unfortunate death" of a patient after "inappropriate admission" to the ophthalmology ward. Consultants said guidelines were being ignored "under pressure to admit patients in order to avoid the four-hour target for patients in A&E".

On 15 April, doctors discussed "a further case of a patient with gastro-intestinal infection" admitted inappropriately to a ward. The minutes say: "Andrew Kirk promised to write again to Ruth [Harrison, the chief executive] regarding this matter."

On 13 May, doctors discussed patients being admitted from A&E to the day-surgery ward where there were "inappropriate toilet and washing facilities" and "no infection-isolation facilities".

Buckinghamshire Hospitals NHS Trust said concerns of staff had been discussed many times by the board and appropriate action taken. "The Trust strongly refutes any suggestion concerns about C. difficile have not been treated with the utmost gravity," it said.

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