Inspections to fight superbugs

Wednesday, November 12, 2008

Every hospital in Scotland will be subject to random inspections as part of the Scottish government’s push to improve cleaning standards and infection control practices within the NHS.

The move follows an independent review of cleaning standards within the NHS, which found that cleaning procedures were not being carried out correctly in some areas. Dust levels and unclean surfaces were found at several sites.

Independent inspections, to be carried out by a new body – the Care Environment Inspectorate – will focus on standards of cleanliness and hand hygiene and will also seek to test levels of understanding and compliance among healthcare workers. The inspectorate will carry out unannounced visits on the basis of identified risks, with all boards being visited every year. Every acute hospital in Scotland will be visited at least once in any three year period.

Making the announcement, Health Secretary, Nicola Sturgeon, said the new arrangements would give an enhanced, more independent and more transparent model of scrutiny and give greater assurance to the public that hospitals are clean and safe.

"The review highlighted the need for a much more transparent process to assure the public that the care environment in our hospitals is safe and that processes are in place to prevent, control, detect and tackle infections and related issues.

"The inspections will provide a level of rigour, frequency and depth of inspection that we don’t get with the current system of self-assessment which has been criticised for being too reliant on self reporting, too disjointed and not as transparent for the public as it should be."

Annual reports will be produced for each NHS board together with a national overview report, resulting in improvement plans being drawn up for each board, with progress being monitored and followed up through further visits by the inspectorate.

Sturgeon said that, although "disappointed" that the review uncovered poor standards in some hospitals, the findings were related to particular health boards, "not for all, and not even for the majority".

"Action plans have been agreed with those boards where failings were identified and action is underway to address the issues.

"The independent inspectorate will provide ongoing continuous assurance that standards are meeting the standards that people expect."

The Scottish government has also announced that single rooms for patients will become the norm across Scotland, with all new build hospitals – such as the new Southern General Hospital in Glasgow – being required to provide 100 per cent single room accommodation. Refurbishment projects should ensure that at least 50 per cent of accommodation is for single rooms.

"This is a long term aspiration," said Sturgeon. "It’s a rolling programme that will see more and more single rooms as we continue to develop and modernise our hospital estate.

"With refurbished buildings, it will not always be clear cut because there are constraints imposed by the fabric, condition and design of the building but we want to get as close to 100 per cent in refurbishment projects as possible with a clear minimum of 50 per cent."

Sturgeon said that both measures were key to the ongoing fight to reduce the rate of infections in Scotland’s hospitals, which she believes is "the single thing most likely to undermine public confidence in the NHS".

"We are seeing signs for encouragement," Sturgeon added. "The rates of MRSA in our hospitals are falling and the statistics for the most recent quarter suggest a reduction in C. Difficile cases, although it is far too early to determine whether that represents a longer term trend or not.

"However, there is no room for complacency and we must work across a whole range of initiatives to make even more progress."

Meanwhile, Conservative public health minister, Jack Carlaw, while welcoming the moves, said there was still a "great deal more" to be done.

"We need to know infection trends on a ward by ward basis. The current practice of collating figures by health board area only has allowed problem wards and hospitals to go unnoticed for too long, with disastrous consequences. This must change.

"The Government must also ensure that the recently introduced ‘modern matrons’ are given full authority to keep our hospital wards clean. All staff – from consultant to cleaner – should be made answerable to modern matrons."