New model cleaning contract will help improve hospital standards, UK

Main Category: MRSA / Drug Resistance
Article Date: 08 Dec 2004 - 9:00 PDT

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New guidance to help ensure hospitals have clear and binding contracts to deliver high standards of cleaning was published today.

The guidance provides:

-- A best practice guide on evaluating and awarding contracts so that quality is considered alongside price

-- Revised National Specifications for Cleanliness which set out clearly the standards which hospitals should provide as a minimum

-- The recommended minimum cleaning frequencies which need to be followed

-- A revised Healthcare Facilities Cleaning Manual to reflect changes in cleaning technologies and practices

Health Minister, Lord Warner, said:

"Hospital cleanliness and reducing infection rates are everyone's business. This guidance sets out clearly how often different areas of a hospital should be cleaned and what level of cleanliness is required. This means both hospitals and cleaning firms know what is expected. This is just the latest step in our drive to improve cleanliness and lower rates of infection."

Also announced today were the PEAT (Patient Environment Action Team) scores for hospitals in England. PEAT teams include people from outside the trust, infection control personnel and patient representatives and provide a local "snapshot" of environmental cleanliness and food standards on the day.

PEAT scores for England after second visit by teams

Excellent 118 (10%)

Good 456 (38.5%)

Acceptable 583 (49%)

Poor 24 (2%)

Unacceptable 3 (0.5%)

After the first round of visits by these teams in 2004, 90 out of 1,184 hospitals rated Poor or Unnacceptable for cleanliness. A range of actions were taken to improve cleanliness and after the hospitals were revisited again just 27 were found to be Poor or unnacceptable. Almost half of hospitals rated Excellent or Good. These scores allow hospitals to measure cleanliness and address specific areas of concern. A lot more work is needed to bring trusts to the highest standards - especially among those with an acceptable rating.

Also announced today was the positive uptake of the National Patient Safety Agency (NPSA) CleanYourHands campaign which requires all hospitals to have alcohol hand rubs near every patient and CleanYourHands information posters. This has been implemented in 97 Trusts so far (nearly 1 in 3) and another 30 have signed up to take part in the new year.

Chief Nursing Officer, Christine Beasley said:

"This is another vital step in putting hospital cleanliness and infection control at the top of the agenda. To improve standards we must know when things aren't up to scratch and the new model contract helps hospitals to do this. The uptake of the CleanYourHands campaign is another encouraging sign of the staff and patients in the NHS working together to combat infection."

Notes for Editors

1. The national PEAT scores and new guidance on contracting cleaning can be found at www.cleanhospitals.com

2. MRSA - context

-- Some degree of HCAI is inevitable (6-10% of patients in developed world have HCAI)

-- Staphylococcus aureus is a very common cause of bacterial infections - boils, carbuncles, infected wounds, deep abscesses and bloodstream infection (bacteraemia)

-- First described in the 1880s. By 1959, 90-95% of clinical isolates of S.aureus were resistant to penicillin

-- Between 1993 and 1997 moved from 5% to 30% of S. aureus becoming resistant to methicillin (hence methicillin resistant Staphylococcus aureus)

-- Now setting at just over 40%

3. Key actions so far

-- Circular issued to all Trusts about infection control teams (Feb 2000)

-- PEAT inspections commenced (autumn 2000)

-- Mandatory surveillance for MRSA blood stream infections introduced (April 2001)

-- National Standards for Cleanliness issued (April 2001)

-- Winning Ways (Dec 2003) - strategy to tackle HCAIs

-- NHS Cleaning Manual issued (April 2004)

-- Towards Cleaner Hospitals and Lower Rates of Infections (July 2004) - pulls together cleanliness and infections control strands of campaign

4. Bringing All Up to the Level of the Best

-- Directors of Infection Prevention and Control (DIPCs)

- established in every trust
- first conference in October
- annual local reports in 2005

-- Trust Boards and Chief Executives to exercise leadership and listen to DIPCs

-- DH workshops to spread best practice - best performing trusts to share experiences with Trusts with poor MRSA rates

5. For further details please contact Ben Lewis on 020 7210 4990 or Claire Rich on 020 7210 5238 at DH Media Centre

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