Quarter of NHS trusts fail to hit hygiene targets

One in four NHS trusts has failed to meet minimum hygiene standards and is putting patients at risk of superbugs such as MRSA and C. difficile.

The number of failing trusts is sharply up on a year ago, suggesting declining levels of cleanliness in the NHS. But the Healthcare Commission, the government's NHS inspectorate, which has published the figures in a report today, said the apparently worsening picture reflected greater openness on the part of trusts and not dirtier wards.

In April, the Health Protection Agency (HPA) reported that C. difficile, which causes a potentially lethal bowel infection, was still spreading through the NHS with cases up 8 per cent on the previous year to a record total of 55,681. It blamed inadequate infection control, poor cleanliness and misuse of antibiotics.

There was better news on MRSA infections which fell 7 per cent in the quarter from October to December 2006, continuing a declining trend since 2004, although the HPA said it was too soon to tell whether the fall was being sustained.

Today's report from the Healthcare Commission shows that 55 trusts, 14 per cent of the total, were unable to confirm that they had systems in place to "keep patients, staff and visitors safe" and to ensure "the risk of healthcare acquired infection to patients is reduced".

That compares with 7.2 per cent of trusts who failed the standard last year, half as many. On two other hygiene standards relating to decontamination and the healthcare environment, the number of failing trusts also increased.

Four NHS district general hospital trusts failed on all three hygiene standards - the Royal Cornwall, Buckinghamshire, North Devon and Surrey and Sussex.

Overall, 99 trusts out of 394 admitted that they were not meeting parts of the Hygiene Code, introduced last year by the commission to improve cleanliness.

Opposition MPs seized on the figures. The Liberal Democrat health spokesman, Norman Lamb, said: "It is wholly unacceptable that one in four hospitals are still failing to meet required hygiene standards. There has to be a cultural change within hospitals. Three-quarters of hospitals are successfully implementing effective measures - there is no excuse for others not to follow.

"There has to be a zero tolerance approach to tackling superbugs. It is shocking that after countless Government initiatives the number of hospitals failing to protect patients from these infections has doubled."

Surveys show that worries about superbugs such as MRSA top patients concerns about going into hospital. David Nicholson, the chief executive of the NHS, said last year that tackling hospital infections would be his main priority for 2007.

The commission introduced the Hygiene Code in October last year. The code imposes 11 duties on trusts ranging from providing isolation facilities to infection control teams to minimise the threat from superbugs. Last month it announced it would carry out spot checks at 120 NHS trusts over the next year.

The Healthcare Commission's report shows 40 per cent of NHS trusts met all the performance standards, based on their own self declarations, up from up from 34 per cent in 2005-6. These will be subject to spot checks over the summer before the final results are published in the autumn.

Superbugs

* C-difficile

Clostridium difficile can cause diarrhoea and sometimes ulceration and bleeding of the intestines, once the normal intestinal bacteria has been killed off by antibiotics. It is passed through contact

* MRSA

Methicillin-resistant Staphlococcus aureus, pictured, is dangerous in the bloodstream of someone who is ill. It can be passed around by physical contact or from mouth to nose

* PVL

Panton-Valentine leukocidin, a toxin produced by strains ofS. aureus, attacks white blood cells, destroys tissue causing skin infections and can cause blood poisoning and pneumonia.