Healthcare Commission Issues Hygiene Code Improvement Notice To Ashford And St Peter's Hospitals NHS Trust

Main Category: Public Health
Article Date: 23 Jun 2008 - 4:00 PDT

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Trust failing over mattress cleaning and decontamination of equipment at Ashford Hospital

The Healthcare Commission announced that it has issued an improvement notice to the Ashford and St Peter's Hospitals NHS Trust, requiring changes to its infection control practices.

Immediate Action Taken On Healthcare Commission Improvement Notice - Hospital Acquired Infections Continue To Fall At Ashford & St. Peter's Hospitals

The Commission found the trust was in breach of the hygiene code, which sets out 11 mandatory duties for NHS trusts to reduce and control healthcare-associated infections.

The Commission found breaches of:

- Duty 4(f), which requires trusts to ensure that there are effective arrangements for the appropriate decontamination of medical instruments and other equipment.

In particular, the Commission found the facilities used to clean mattresses at Ashford Hospital are inadequate and have the potential to increase the risk of spreading infection. Also, it was unclear which staff members were responsible for decontamination.

The trust must close the mattress cleaning facility immediately and make alternative arrangements to decontaminate mattresses.

The trust must also review the structure of reporting and make clear which staff members are accountable for decontamination of medical instruments and other equipment.

- Duty 3, which requires trusts to assess the risks of acquiring healthcare-associated infections and to take action to reduce or control such risks.

In particular, the Commission found that the trust had not properly assessed risks relating to the decontamination of mattresses at Ashford Hospital. Also, the trust had not made steps to assess risks associated with the use of benchtop sterilisation equipment, which are small portable sterilisers used to decontaminate medical instruments. The oral surgery unit at Ashford Hospital uses this equipment. The Commission sent a letter to all NHS acute trusts in April this year, asking that trusts review their use of benchtop sterilisers to ensure it is in line with national guidance.

The trust must ensure that they are making suitable assessments of the risks relating to all decontamination processes at the trust.

The Commission has given the trust until 17 July to address these issues. The strategic health authority, NHS Southeast Coast, will oversee this work. The Commission will inspect the trust again within 10 days of the deadline passing.

Ashford and St Peter's Hospitals NHS Trust is the fourth trust to be issued with an improvement notice. The trust runs two hospitals on the outskirts of west London: Ashford Hospital in Ashford, Middlesex, and St Peter's Hospital in Chertsey, Surrey.

The Commission made unannounced visits to both hospitals on Thursday 5 and Friday 6 June 2008. No breaches were identified at St Peter's Hospital.

The visit is part of the Commission's biggest ever programme of inspections relating to healthcare-associated infection; in 2008/09, it will visit every trust in England.

Christine Braithwaite, healthcare-associated infection lead, at the Commission, said: "Proper decontamination of mattresses and equipment at Ashford Hospital is vital to stop infections from spreading. This is very important on behalf of patients.

"We know that the trust has started to act on the improvement notice. We will be visiting the trust again and we will expect to see full compliance with the code."

Notes

The Government gave the Commission the power to issue improvement notices for serious breaches of the hygiene code when the code was introduced in October 2006. The code outlines 11 compulsory duties to prevent and manage healthcare-associated infections (HCAIs) such as MRSA and Clostridium difficile.

- A copy of the hygiene code (The Health Act 2006: Code of practice for the prevention and control of healthcare associated infections) is available here.

- Ashford and St Peter's Hospitals NHS Trust was rated as "fair" for quality of services and "weak" for use of resources in the 2006/07 annual health check carried out by the Healthcare Commission.

- In their most recent declaration for the 2007/08 annual health check, the trust declared compliance against the three standards relating to the hygiene code (C4a, C4c and C21).

- The Commission issued three improvement notices in its first round of inspections. This is the first improvement notice to be issued the new round of inspections, which commenced in April this year.

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.

The Healthcare Commission

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