Doctors claim major infection control ‘deficiencies’ at region’s hospitals

The study looked at trusts’ adherence to Public Health England guidance around limiting the spread of covid-19 within orthopaedic services.

The study found patients were routinely being allocated to hospital beds before they had been confirmed as covid-negative, “thus allowing spread of covid-19 not only between patients but also between nursing and medical staff”.

Fewer than half of patients were nursed with the appropriate screens in place, while it was uncommon for doctors to be tested regularly (See image for more survey results).

Separate statistics published by NHS England suggest almost 20 per cent of new covid cases in North West hospitals from August to December were likely to be nosocomial, meaning they were acquired on the wards.

This was a higher proportion than any other region (see table below).

The research paper surveyed orthopaedic trainees across 23 hospitals and has been published in the Journal of Hospital Infection. The authors included Saleem Mastan, of Wrightington, Wigan and Leigh Foundation Trust, and Charalambos Charalambous, of Blackpool Teaching Hospital FT.

It said: “Older age, male sex, obesity, diabetes and recent surgery may increase vulnerability to adverse outcomes from covid-19 infection. Indeed, hip fracture patients were found to be extremely vulnerable, with a seven-fold increase in 30-day mortality of up to 36 per cent compared to 6.9 per cent in the pre-covid-19 era.”

But it concluded: “Our survey clearly identifies major deficiencies in the implementation of PHE recommendations for limiting nosocomial infection in hip fracture patients.”

Trusts in the North West which have had the highest proportions of probable nosocomial cases between August and December, according to HSJ analysis, included Lancashire Teaching Hospitals FT, Stockport FT, and University Hospitals of Morecambe Bay FT. Trusts with the lowest proportions included St Helens and Knowsley Teaching Hospitals Trust and Mid Cheshire Hospitals FT. Poor quality and cramped estates are one likely factor driving high rates of nosocomial infection.

Jackie Bird, NHS England’s regional chief nurse, said: “The North West has seen some of the most sustained and highest rates of community infection across the country, and as the Office for National Statistics has repeatedly made clear, when infections in the community are high NHS staff and patients are more likely to be affected, so increased rates in staff and patients track an almost twentyfold increase in covid cases since August.

“Hospital trusts across the North West have been asked to rigorously follow regularly updated guidance on infection prevention and since asymptomatic staff tests kits were made available for the first time by the government’s test and trace programme in November, almost half a million staff have been tested to help to keep infection rates as low as possible.”

Regional breakdown of hospital-acquired covid cases