Foundation trusts have hit back at criticism from Monitor over the number of hospitals failing to reduce MRSA rates.

Monitor, the foundation trusts' regulator, has focused on MRSA in its report for the nine months to the end of last December, published this week. This reveals that by the end of last year, 24 foundation trusts had breached their full-year target for reducing MRSA and a further 11 risked breaching the target.

Seven trusts had been summoned to meetings with Monitor. They were Calderdale and Huddersfield, Doncaster and Bassetlaw Hospitals, Lancashire Teaching Hospitals, Poole Hospital, Northumbria Healthcare, Southend University Hospital and the Royal Bournemouth and Christchurch Hospitals.

The report states that in some cases, "the board is not adequately anticipating risks and then providing the leadership, challenge and engagement needed to mitigate those risks".

In addition, "boards are not directing enough focus and effort towards co-operation in the delivery of integrated local healthcare solutions".

Monitor has written separately to the chairs of four trusts that have the highest numbers of MRSA cases in the sector - Heart of England, Newcastle upon Tyne Hospitals, University Hospital Birmingham and Bradford Teaching Hospitals.

Foundation Trust Network director Sue Slipman said the system penalises those that already had low infection rates.

Poole Hospital chief executive Sue Sutherland said the MRSA target agreed with the local primary care trust had been "over-ambitious".

Unlike the C difficile target, it was based on the number of MRSA infections in patients' bloodstreams rather than the number of bed days. This meant it "takes no account of case-mix or number of people actually going through the organisation," she said.