Infection control: C difficile measures improve at Stoke Mandeville

Overall the commission said it was satisfied the trust had worked hard to address failings identified in its original investigation. The findings were due to be released today, at the same time as a report by the Health and Safety Executive, which was expected to rule out criminal negligence.

The commission found marked improvements in ward cleanliness, staff training and bed management. Inspectors said infection control was now a top priority and the trust met all 11 requirements of the hygiene code.

'We are encouraged and the staff should be applauded for that,' said Ian Biggs, head of the Healthcare Commission in the South West.

However, the commission said further improvements were needed in areas including staffing levels and some aspects of clinical management of patients with Clostridium difficile.

In particular, some doctors' failure to clean their hands was 'unacceptable'. 'A number of doctors were observed on a number of occasions moving between wards and between patients without washing hands,' the commission's report said.

Trust chief executive Anne Eden told HSJ the trust was taking a strong stance. She confirmed three doctors had already been given verbal or written warnings.

'It's a national problem, where other staff do fare better, but we're taking it very seriously indeed,' she said. 'It's about keeping the message going loud and clear and getting patients and other members of staff challenging doctors.'

The trust's most recent audit of hand hygiene found 90 per cent compliance overall, with 81 per cent among doctors.

Overall Ms Eden said the trust was pleased with the commission's report, which she described as a fair assessment of progress. 'There's no doubt things have changed in the last 11 months. We're one of the top performers in the country for C difficile rates,' she said.

The commission's original investigation followed two serious outbreaks of C difficile at Stoke Mandeville Hospital between October 2003 and June 2005, in which 334 patients contracted the infection and at least 33 people died.

At the time the commission highlighted serious failings by trust managers, who have since left the organisation.

However, the HSE was expected to clear them of acting irresponsibly and conclude there was no evidence the trust had breached health and safety law.

Four months ago, HSJ revealed that the HSE's draft report supported senior managers' handling of the outbreak (for more background, click here).

The commission said it had worked closely with the HSE throughout. 'There are no significant differences between what we and the HSE have to say,' a commission spokesman said.