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