Trusts have failed to hit targets for reducing MRSA and many are not meeting basic standards for hygiene and cleanliness.

The Healthcare Commission’s annual health check found overall performance on hygiene standards had slipped. Dozens of trusts are failing to live up to the hygiene code for cutting hospital infections.

Progress on cutting MRSA levels has been slow and overall performance against the target to reduce the infection is worse than last year.

The findings will ramp up pressure on health service managers struggling to eliminate infections such as MRSA and Clostridium difficile from hospital wards.

However, Healthcare Commission chief executive Anna Walker told HSJ the slip in performance was partly due to the fact that standards on hygiene were much tougher.

The commission looked at trusts’ performance against a raft of core standards.

Of the five standards where national performance was worst, two were linked to hygiene.

A total of 111 trusts failed on one or more standards linked to the tougher hygiene code introduced in October last year.

The commission found 41 trusts failed to comply with a standard that requires them to limit the risk of infection through basic hygiene precautions and cleanliness. A further 14 trusts could not show they met the standard. Last year nearly 93 per cent met the standard, compared with 84 per cent this year.

The number of trusts meeting standards on decontaminating medical devices between patients and providing clean environments has also fallen.

Many trusts are also failing to hit national targets on MRSA, which require a year-on-year improvement. Nine trusts had failed to hit their MRSA targets for two years running.

The findings will boost fears the government will not meet its target of halving MRSA rates by March 2008. In 2006-07, 76 out of 172 acute and specialist trusts met targets on cutting MRSA compared with just over half the year before.

The commission said targets for 2006-07 had been more demanding, yet 59 trusts had managed to keep on track for two years while 25 trusts had improved their performance this year.

‘Infections are being reduced, but progress so far has been slower than planned and this has led to a worsening of trust scores overall,’ the commission’s report said.

The commission is going into 120 trusts this year as part of efforts to boost hygiene.

‘What we are seeing is that where trusts take infection control seriously you can see dramatic reduction in infection,’ Ms Walker said.

‘What has emerged from all the visits we’re doing at the moment is a similar story to Maidstone and Tunbridge Wells [where C difficile killed at least 90 people] - not in terms of the level of failure but in terms of what it is that needs to be put right.’

She said trust boards must make infection control a priority from the board to the ward.

Other priorities were staff training and ensuring that isolation facilities were in place.

The best and worst

‘Double excellent’ trusts

  • Basingstoke and North Hampshire foundation trust

  • Birmingham Children’s Hospital foundation trust

  • Calderdale and Huddersfield foundation trust

  • Cambridge University Hospitals foundation trust

  • Chelsea and Westminster Hospital foundation trust

  • Chesterfield Royal Hospital foundation trust

  • Frimley Park Hospital foundation trust

  • Guy’s and St Thomas’ foundation trust

  • Heart of England foundation trust

  • Liverpool Women’s Hospital foundation trust

  • Papworth Hospital foundation trust

  • Queen Victoria Hospital foundation trust

  • Royal Marsden foundation trust

  • Salford Royal foundation trust

  • Sheffield Children’s foundation trust

  • Sheffield Teaching Hospitals foundation trust

  • South Essex Partnership foundation trust

  • South Staffordshire Healthcare foundation trust

  • Yeovil District Hospital foundation trust

‘Double weak’ trusts

  • Cumbria primary care trust

  • Devon primary care trust

  • East and North Hertfordshire primary care trust

  • Great Western Ambulance Service trust

  • Leicestershire County and Rutland primary care trust

  • Luton Teaching primary care trust

  • Maidstone and Tunbridge Wells trust

  • Mid Essex primary care trust

  • Northern Devon Healthcare trust

  • Royal Cornwall Hospitals trust

  • Royal United Hospital Bath trust

  • Scarborough and North East Yorkshire Healthcare trust

  • Sheffield primary care trust

  • Surrey and Sussex Healthcare trust

  • Surrey primary care trust

  • West Hertfordshire Hospitals trust

  • West Hertfordshire primary care trust

  • Wiltshire primary care trust

  • Worcestershire Acute Hospitals trust

  • Yorkshire Ambulance Service trust

To read more on infection targets, click here

For more HSJ coverage of the health check, click here