North London Trust Makes Progress On Infection Control

Main Category: MRSA / Drug Resistance
Article Date: 21 Dec 2007 - 3:00 PDT

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Barnet and Chase Farm Hospitals NHS Trust has complied with the requirements of the hygiene code improvement notice.

The Healthcare Commission yesterday announced that Barnet and Chase Farm Hospitals NHS Trust has made improvements in infection control.

The trust is now compliant with the requirements of an improvement notice, issued on July 5 2007, which required immediate changes to infection control practices.

It was the first trust to be issued with an improvement notice for breaches of the hygiene code. The code outlines compulsory duties to prevent and manage healthcare-associated infections such as MRSA and Clostridium difficile. All NHS trusts should be compliant with these duties.

The issuing of an improvement notice is a legal power given to the Commission by government in October 2006. Notices are issued only when breaches of the hygiene code are serious.

Following an unannounced visit to Chase Farm Hospital, part of Barnet and Chase Farm Hospitals NHS Trust, on June 7 2007, the Commission found serious breaches of the hygiene code. Four duties were examined, covering management systems, assessment and management of the risk of infection, provision of a clean and appropriate environment for patients, and provision of isolation facilities for infected patients.

The Commission conducted a follow up visit to Chase Farm Hospital on October 31 2007 to assess the trust's compliance with these four duties.

The Commission found that Barnet and Chase Farm Hospitals NHS Trust has made progress and is now compliant with the improvement notice. The trust showed evidence that it has:

- reviewed, documented and acted on the arrangements for microbiology services

- developed and implemented a programme of staff training on infection control - attendance is monitored and reported to the board

- enhanced information provided to staff, patients and visitors on infection control

- developed and implemented analyses of the root causes of infection

- improved hand wash facilities and antibacterial rubs, along with messages to staff about their use, and

- developed policy for and raised awareness of the use of isolation facilities for infected patients.

However, the Commission has made a number of recommendations to help ensure that the trust continues the work it has started. The strategic health authority, NHS London, has been asked to oversee this work.

The recommendations are that the trust should:

- ensure that there should be monitoring of agreements with neighbouring NHS trusts which provide microbiology services

- ensure that the current training plan is completed and extended beyond March 2008 - continue its recruitment plans to ensure that staffing levels of infection control staff are adequate and encourage infection control nurses to visit clinical areas routinely as well as to address specific issues

- plan when it will print new MRSA leaflets and remove the old ones from circulation as soon as possible

- continue to analyse the root causes of infection, involving local clinical staff and ensuring that all relevant information is included, and

- ensure policies are updated when appropriate.

Anna Walker, Chief Executive of the Healthcare Commission, said: "I am pleased that the trust has implemented our requirements and is now compliant with the improvement notice. Patients can be reassured by these improvements.

"It is important that the trust continues its progress and implements the recommendations we have made following our most recent visit. The SHA will see that this happens."

"This is about giving reassurance to patients and the public that everything is being done to minimise the risks of healthcare-associated infection."

The visits to the trust were part of the Commission's biggest ever programme of inspections relating to healthcare-associated infection. By March 2008, the Commission will have inspected 120 NHS trusts. From April 2008, every NHS trust will be inspected on infection control.

Barnet and Chase Farm Hospitals NHS Trust: Hygiene code inspection summary report (pdf 59kb) (opens new window)


Notes

-- Barnet and Chase Hospitals NHS Trust provides general and specialist care from two main hospital sites, Chase Farm Hospital and Barnet Hospital. It serves the areas of Enfield, Barnet, East Harrow, South Hertfordshire, South Essex, Waltham Forest. Each year, more than half a million people are treated in Barnet and Chase Farm wards or seen in outpatient and day services.

-- The four duties from the hygiene code with which the trust was non-compliant are, in full:

- Duty 2 - The trust must have in place appropriate management systems for infection prevention and control.

- Duty 3 - The trust must assess the risk to patients of acquiring healthcare-associated infections (HCAI) and take action to reduce or control such risks.

- Duty 4 - The trust must provide and maintain a clean and appropriate environment for health care.

- Duty 8 - The trust must provide adequate isolation facilities for infected patients. • Barnet and Chase Farm Hospitals NHS Trust was rated as good for quality of services and weak for use of resources in the 2006/07 annual health check carried out by the Healthcare Commission.

Information on the Healthcare Commission

The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services.

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.

The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.

Healthcare Commission