Acute trust boards are not taking enough responsibility for controlling infection in their hospitals, the healthcare watchdog has warned.

Spot checks on 43 hospitals by the Healthcare Commission have revealed concerns that boards are not regularly discussing opportunities for improvement or ensuring infection control data is analysed effectively.

In an interim inspection report on hygiene code compliance, the commission said ‘most’ of the boards needed to do more to outline their collective responsibility for minimising risks of infection or incorporate the code fully into the trust’s governance and performance frameworks.

The findings were revealed at a commissioners’ meeting at the Healthcare Commission last week.

Commissioner Professor Deirdre Kelly, who is also liver unit director at Birmingham Children’s Hospital, said the results were ‘very disappointing’.

‘The hygiene code doesn’t seem to be hitting the headlines in trust boards,’ she said. ‘If its importance isn’t clear to boards, it’s going to be difficult to spread the message elsewhere.’

The findings follow attempts by the two main political parties to outdo each other at their annual conferences on new policy initiatives to tackle hospital-acquired infections.

Prime minister Gordon Brown announced last week that every ward would have a ‘deep clean’ and that matrons are to be given powers to hold NHS cleaning services to account. Health secretary Alan Johnson said he wanted to give nurses more access to trust boards (for more background, click here).

This week, shadow health secretary Andrew Lansley called for a ‘search and destroy’ attack on superbugs. He told HSJ this meant ‘wherever there is an outbreak of MRSA they will seek to eradicate the presence of MRSA and prevent its re-occurrence and reintroduction into the hospital’.

He hit out at Labour’s promised deep clean as a ‘gimmick’ and said: ‘Either you do the search and destroy strategy or you don’t. What you don’t do is one bit of it, deep cleaning, and then find a year down the line all the reservoirs of infection are still there.’

The hygiene code, which came into force in October 2006, outlines 11 compulsory duties to prevent and manage superbugs such as MRSA and Clostridium difficile.

By next June the Healthcare Commission will visit 120 acute trusts that it suspects might be at risk of non-compliance. The interim report represents findings from the first 43 visits. Separate inspections are carried out in the annual healthcheck ratings, which from this year will also monitor compliance with the hygiene code.

Improvement notices are handed out to trusts that fail in their hygiene duties; this has happened in only one case so far, at Barnet and Chase Farm Hospitals.

Royal College of Nursing head of policy Howard Catton said it was important for trust boards to take collective responsibly for infection control.

‘Sometimes there can be the tendency to see it as the responsibility of one director, often a clinician. It needs to go beyond this. The senior nurse needs the support of the finance director for funding, human resources for training and contracting departments to look at staff systems,’ he said.

Healthcare Commission chief executive Anna Walker said: ‘I have written personally to all strategic health authority chief executives to draw their attention to trusts that have either delivered non-compliance or that we have concerns about in relation to the hygiene code.’

NHS Confederation deputy policy director Jo Webber said: ‘Trust boards are taking this seriously but it’s one of a lot of priorities.’

The deep clean needed to be seen as one part of an overall package to tackle healthcare-acquired infections, she said.

The Department of Health is proposing to force chief executives, by law, to report MRSA and C Difficile outbreaks to the Health Protection Agency (for more background, click here).

The Healthcare Commission is next week expected to publish a damning report into the management of C Difficile at Maidstone and Tunbridge Wells trust.

For more analysis from HSJ’s editor, click here