Press Release - Reducing healthcare associated
infections in hospitals in England
12 June 2009
The Department of Health has met its target to reduce MRSA
bloodstream infections by 50 per cent by 2008 and has made
encouraging progress towards its target to reduce Clostridium
difficile infections, according to a National
Audit Office report published today. However, blood stream
infections due to other causes may be increasing. There is
also no national data that captures information on some of the most
common healthcare associated infections, such as urinary tract
infections and pneumonia.
The Department introduced a target to reduce MRSA across all NHS
trusts by 50 per cent by 2008 and C. difficile by 30 per
cent by 2010-11. MRSA had been reduced by 57 per cent by the
end of March 2008 and C. difficile by 41 per cent.
While a quarter of trusts have reduced MRSA by more than 80 per
cent, in 12 per cent of trusts there has been an increase in MRSA
infections. Twenty-nine per cent of trusts have reduced
C. difficile by more than 50 per cent, but in 19 per cent
of hospital trusts the numbers of C. difficile infections
have increased.
Since the introduction of targets to reduce
MRSA and C. difficile, the Department has spent some £120
million on central initiatives tackling healthcare associated
infections. There have also been unquantifiable
administrative costs and local expenditure on the drive to reduce
infection rates. These central initiatives, together with
action at trust level, have led to savings on treatment of between
£141 million and £263 million, as well as reducing discomfort,
disability and, for some, death that might have been caused by
these avoidable infections.
The Department’s approach to reducing healthcare associated
infections, comprising “must do” targets for reducing MRSA
bloodstream and C. difficile infection rates, close
performance monitoring of these targets, and support and guidance
on infection prevention and control more generally, has been
effective in helping trusts to improve cleanliness and compliance
with infection prevention practices. There has also been a
perceptible change in trust leadership on infections in response to
the challenges of reducing infection rates. The impact has
not, however, been the same in all trusts or, as far as the data
from voluntary reporting shows, for other infections.
Following the Department's intervention to improve recording on
death certificates where MRSA or C. difficile was the
underlying cause or a contributory factor, in 2007 around 9,000
people were reported by the Office for National Statistics as
having died in such circumstances. There is still no national
information on deaths from other healthcare associated
infections.
Amyas Morse, head of the National Audit Office,
said today:
“The Department of Health’s hands on approach to
what seemed, in 2004, to be an intractable problem, has been
successful in reducing MRSA bloodstream and C. difficile
infections. This is a significant achievement and a good
example of what concerted effort can achieve. Inevitably, with a
focused and centrally driven initiative of this kind, the
improvements are not uniform across the NHS and we still don't know
in any meaningful way what impact there has been on other
healthcare associated infections. We have identified a number
of key problems that need to be addressed such as: a lack of robust
comparable data on other infection risks; increases in antibiotic
resistance and poor data on hospital prescribing; and that
compliance with good practice is still not
universal.”
Notes for Editors
-
The term ‘healthcare associated infection’ is
defined as any infectious agent acquired as a consequence of a
person’s treatment by a healthcare provider.
-
The National Audit Office reported on
healthcare associated infections in 2000 and 2004. The
reports are available on the NAO’s website Improving patient care by reducing the risk of
hospital acquired infection: a progress report and The Management and Control of Hospital Acquired
Infection in Acute NHS Trusts in England.
-
In response to the 2004 NAO report the
Department of Health committed to make control and prevention of
healthcare associated infections a top priority and introduced a
target to reduce MRSA by 50 per cent by 2008. In 2007 a
target was set for a 30 per cent reduction in the number of cases
of C. difficile reported in 2010-11.
-
In 2006 an English national prevalence survey
found that eight per cent of patients had an infection acquired
during their hospital stay.
-
A detailed report on how other countries are
tackling healthcare associated infections is available on the NAO
website. Also available on the website is the headline
findings from the trust census, a report on the survey of nurses
and doctors, a report on international comparisons and a
report on an analysis of HPA surveillance data which were
undertaken as part of the report.
-
Press notices and reports are available from
the date of publication on the NAO website, which is at http://www.nao.org.uk/.
Hard copies can be obtained from The Stationery Office on 0845 702
3474.
-
The Comptroller and Auditor General, Amyas
Morse, is the head of the National Audit Office which employs some
900 staff. He and the NAO are totally independent of
Government. He certifies the accounts of all Government
departments and a wide range of other public sector bodies; and he
has statutory authority to report to Parliament on the economy,
efficiency and effectiveness with which departments and other
bodies have used their resources.
Press Notice 38/09
All enquiries to Sarah
Farndale, NAO Press Office:
Tel: 020 7798
5350
Mobile: 07985 274
421