MRSA: "Trusts Must Do Better" Says Minister, UK

Main Category: MRSA / Drug Resistance
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 07 Feb 2006 - 4:00 PDT

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The latest national and trust-level figures on MRSA bloodstream infections are published today by the Health Protection Agency (HPA), showing 3580 MRSA bloodstream infections occurring in NHS Acute settings during April - September 2005.

MRSA bacteraemia reports from NHS acute Trusts in England,
April 2001-September 2005

April-Sept 2001
Number of reports 3616
Oct 2001-March 2002
Number of reports 3665
April-Sept 2002
Number of reports 3584
Oct 2002-March 2003
Number of reports 3806
April-Sept 2003
Number of reports 3749
Oct 2003-March 2004
Number of reports 3956
April-Sept 2004
Number of reports 3525
Oct 2004-March 2005
Number of reports 3689
April-Sept 2005
Number of reports 3580

Around half of trusts are currently on target and half of trusts are behind target to make a 50% reduction in MRSA infections by 2008. Of those who are behind on the target around twenty trusts face a significant challenge and these are the organisations the Department will be working with most closely in the coming months.

Health Minister, Jane Kennedy, said:

"I am disappointed that, despite many trusts making significant reductions in infections, the overall figures do not reflect these improvements. These are early figures from the period at the very start of the comprehensive program of action we have put in place.

"To reinforce the efforts at Trusts that are furthest from their target I am setting up teams of specialists to work with them through 2006. These teams will begin first wave work now at Sandwell, Northumbria and Aintree NHS Trusts who have volunteered for help, and then move on to around seventeen more Trusts through 2006."

"While 7,269 infections is a tiny fraction of the 12 million patients admitted to hospital every year, and more cases are reported now due to better surveillance, any avoidable infection is one too many."

The DH will now offer targeted support for trusts facing the biggest challenges. Targeted support has two main elements:

The first element is the MRSA/HCAI Improvement Programme, the objectives of which are to provide support teams to hospitals that have a significant MRSA problem, to help them:

- Diagnose the issues currently preventing reduction in MRSA bacteraemia numbers

- Develop practical action plans with realistic implementation timescales

- Implement agreed plans and put in place management and support arrangements that facilitate sustained improvement

- Act as a catalyst for other Trusts and demonstrate that by adopting best practice rates can be reduced to lower levels, and at faster rate than previously thought.

These teams will begin work now at Sandwell, Northumbria and Aintree NHS Trusts and then move on to around 20 Trusts in total through 2006.

The second element is the Performance Improvement Network (PIN), consisting of a national network of Trusts with a mixed track record of delivery against their Local Delivery Plans. These Trusts meet quarterly as an action learning set to share best practice and learn from each other. There are currently 21 Trusts that belong to the network.

The Department of Health and the Health Protection Agency also previewed their new enhanced data reporting system today. This is a new online reporting system allowing trusts and the Department and HPA to monitor:

- Location where infection occurred
- Location of patient
- Stage of infection
- Specialty

We will now publish this enhanced reporting data every six months, starting with the next six-month statistics.

We now have one of the best reporting and data systems for monitoring MRSA in the world, allowing us to get to the root of where infections occur most frequently. For example, the enhanced MRSA data collection has enabled us to quantify the risk of infection in Renal settings - as many as 1 in 10 of all MRSA bacteraemias may be arising during renal treatment. To prevent avoidable infections occuring in Renal settings we are:

- Establishing Renal/HCAI Group led by Renal Tsar Donal O'Donahue

- Improving vascular access so more 'permanent' lines can be fitted more quickly, reducing risk of infection

- Developing a programme of activities to ensure good clinical practice on touch techniques when inserting both temporary and permanent lines

Chair of the Renal Advisory Group at DH, Donal O'Donahue, said

"We have known about the risk of incurring MRSA during renal treatment, particularly when using temporary lines, for some time. That is why we included a standard in the Renal National Service Framework covering access to vascular surgery for creation of fistulae, which reduces the risk.

"The enhanced MRSA data collection has enabled us to quantify the risk suggesting that as many as 1 in 10 of all MRSA bacteraemias may be arising due to inadequate vascular access provision. This means this is now a high priority and that is why I have convened a national conference on 16th February to drive home the important messages about raising clinical standards."

1. The national and trust-level data can be viewed at:
http://www.dh.gov.uk/hcai

2. For further information on Saving Lives and other action the Department is taking to help reduce infection please visit:
http://www.dh.gov.uk/reducingmrsa

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