Health Secretary Jeremy Hunt has today announced major plans to drastically reduce infections in the NHS in an urgent bid to save lives and improve patient safety.
On Tuesday this week, he will be addressing an infection control summit in London hosted by the Royal College of Nursing, convening leading experts in the field and announcing Government plans to halve the number of gram-negative bloodstream infections by 2020.
E.coli infections – which represent 65 per cent of what are called gram-negative infections – killed more than 5,500 NHS patients last year and are set to cost the NHS £2.3bn by 2018. There is also a large variation in hospital infection rates, with some hospitals having more than five times the number of cases compared to others.
Infection rates can be cut with better hygiene and improved patient care in hospitals, surgeries and care homes – ensuring staff, patients and visitors are regularly washing their hands. People using insertion devices like catheters, which are often used following surgery, can develop further infections like E. coli if they are not inserted properly, left in too long or patients are not properly hydrated and going to the toilet regularly.
This new drive builds on considerable progress in infection control since 2010 – about which the Health Secretary will say:
“The NHS can rightly be proud that in the last 6 years we’ve reduced the number of MRSA cases by 57% and C. difficile by 45%. These aren’t abstract numbers – they show that we have prevented the needless suffering – sometimes fatal suffering - of over 60,000 people in that period. Because every avoidable infection also has a financial cost, we know that progress has also saved the NHS over half a billion pounds.”
To tackle these problems, the Government’s tough plans include:
- More money for hospitals making the most progress in reducing infection rates thanks to a new £45m quality premium
- The independent CQC inspection regime focusing on infection prevention based on new data on e-coli rates in hospitals and in the community;
- NHS will publish staff hand hygiene indicators for the first time;
- E. coli rates displayed on wards, visible to patients and visitors in exactly the same way that MRSA and C. difficile are currently;
- E. coli rates broken down by local area so the CQC can take action against poor performers;
- New data published enabling patients to see where antibiotics are prescribed incorrectly;
- Improved training and information sharing so NHS staff can learn from the best in cutting infection rates;
- The appointment of new national infection lead, Dr Ruth May;
- £60 million to fund the roll out of Getting It Right First Time programme to eighteen further surgical and medical specialties to improve clinical quality and efficiency and cut post-surgery infection rates – some of which cost the NHS an average of £100,000 each to put right.
The new plan is the latest step in the Government’s pledge to tackle antimicrobial resistance, following stark warnings from the UN and Chief Medical Officer about the grave risk to patient safety.
The Health Secretary is expected to set out the scale of the challenge in a keynote address, saying:
Like a many-headed hydra the curse of dangerous infections comes back to haunt us in different ways despite our progress since 2010 – over the past year we have had over 38,000 e coli bloodstream infections which constitute the majority of gram negative infections and the Sepsis Trust estimates that there are currently 150,000 cases of sepsis every year.
Even worse some of these infections are completely unresponsive to modern antibiotics. Post-surgical infections are also too frequent – I know of an elderly man who went into hospital for a knee operation, ended up with an infection and now has less mobility and more pain than before. Understandably he says he wishes he had never had the operation.
Alongside the plan to reduce E. coli rates, Mr Hunt is also allocating an additional £60 million to roll out the ‘Getting It Right First Time’ programme, first pioneered by Professor Tim Briggs in orthopaedics, to another eighteen surgical specialties. The initial pilot investment of £2.5 million is being built on, and the programme seeks to improve patient experience by ensuring the work of the best and most successful clinicians is replicated across the health service, including cutting infection rates resulting from surgery. For hip and knee replacements, currently some hospital providers have rates of post-operative infection that are 25 times higher than the best performers.
Rolling out the Getting It Right First Time programme will see a big focus on infection control - transforming the lives of hundreds of thousands of patients every year and saving the NHS £1.5 billion each year.
Health Secretary Jeremy Hunt is expected to say:
Taken together, these measures are intended to achieve a dramatic reduction in hospital infections, reducing enormous human pain and suffering in the process. They will make us better at knowing when to use antibiotics and better at knowing when not to use them. They will save doctors and nurses time, and save the NHS money.
But most of all they will be another vital step in making NHS care something we can all be proud of as the safest and highest quality anywhere on the planet.
The aim of these plans is to boost hand washing amongst NHS staff and improve how people with conditions like urinary tract infections are cared for. UTIs are treated with insertion devices like catheters which can often lead to further infections like E. coli.
Targeting preventable infections like E. coli, which has increased by a fifth in the last five years, will make hospitals, surgeries and care homes safer for patients and reduce the need for anti-biotics, therefore reducing the opportunity for bugs to develop a resistance to them.
A third of E. coli infections are now resistant to antibiotics and those who are infected with a resistant strain are twice as likely to die as those who pick up a non-resistant strain.
Dr Ruth May, new national infection and prevention lead, said:
“This is a clear plan to achieve real change across the NHS focusing on a combination of strict oversight from the CQC and the collection, publication and intelligent use of data which will ensure organisations improve infection control and help us to make sure poor performers get the support they need to improve quickly."
This new drive builds on considerable progress in infection control since 2010 – about which the Health Secretary will say:
“The NHS can rightly be proud that in the last 6 years we’ve reduced the number of MRSA cases by 57% and C. difficile by 45%. These aren’t abstract numbers – they show that we have prevented the needless suffering – sometimes fatal suffering - of over 60,000 people in that period. Because every avoidable infection also has a financial cost, we know that progress has also saved the NHS over half a billion pounds.”
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