• NHSE proposes new targets aimed at reducing four bloodstream infections
  • Rates of E coli, MSSA, klebsiella and pseudomonas on the rise
  • Fines for missing MRSA and C difficile targets also set to be scrapped after infection rates fall.  

Trusts and clinical commissioning groups face new annual targets designed to combat rising levels of four bloodstream infections, but sanctions relating to MRSA and C difficile could be scrapped.

NHS England is proposing new targets aimed at reducing levels of E coli, MSSA, klebsiella and pseudomonas be included in the 2020-21 NHS standard contract.

At the same time, financial sanctions for providers failing to reduce levels of MRSA and C difficile are set to be scrapped. NHSE said the year-on-year reductions in the rates of these bloodstream infections means the current fines are no longer fit for purpose.

MRSA rates reduced by 81 per cent over the 10 years between 2007-08 and 2017-18. In the same period, rates of C difficile fell by 76 per cent.

However, E coli infections increased by 27 per cent between 2012 and 2018, while MSSA rates have gone up by 63 per cent since 2011, according to Public Health England data.

NHS Providers policy adviser for quality Ella Fuller said it “made sense” for the standard contract to reflect the general rise in rates of E coli, MSSA, klebsiella and pseudomonas.

However, she added: “While it is right that trusts are held accountable for how they perform, all targets must be considered in the context of the significant resource and operational pressures facing trusts. 

“We know that high bed occupancy rates, overcrowding and understaffing are factors behind the spread of hospital-acquired infections. Patient safety is at increasing risk in many trusts more broadly due to rapidly rising demand, workforce shortages and underinvestment in upgraded and new facilities.”

Patient safety alerts

NHSE also wants to introduce a new requirement for trusts to implement national patient safety alerts within designated time scales.

Data released by NHSE in December revealed 90 patient safety alerts had not been implemented at 47 trusts within the deadlines specified.

NHS national director for safety Aidan Fowler has been trying to simplify the alerts system, while the National Patient Safety Alerting Committee is establishing new standardised arrangements for the issuing of National Patient Safety Alerts to providers.

The standard contract would also require every provider to designate one existing member of staff to be a patient safety specialist. They would work as part of a network across the country to make sure action on major safety risks is coordinated.

Ms Fuller said: “The creation of designated senior patient safety specialists within trusts is a positive step in principle. However, this role will be carried out by someone with existing duties, and there will need to be clear guidelines and boundaries to their duties and remit. 

“Given the existing pressures on front line NHS staff and managers, these specialists will need to be adequately supported if they are to lead, oversee and coordinate trusts’ strategic approach to patient safety effectively.”

A consultation on the proposed standard contract will run until 31 January.