English trusts urged to pool efforts to reduce healthcare acquired infections

National MRSA programme in Scotland a template for improvements in England, conference told

Health organisations across England should work more closely together to drive down the prevalence of healthcare associated infections such as MRSA and C.difficile, experts said this week.

Speaking at the Infection Prevention 2012 conference in Liverpool yesterday, Claire Kilpatrick, a consultant on patient safety at the World Health Organization (WHO), said a national drive across Scotland had showed that, when health boards worked together with the same aim in mind, improvements could be made to infection control processes.

Kilpatrick has worked closely with Scottish trusts since they began to take a closer look at infection prevention 11 years ago. For the past eight years, health boards have had dedicated ‘cleanliness champions’ and for the past five years there has been a national campaign aimed at improving hand hygiene. Another key driver for the joined-up approach seen north of the border was ministerial pressure through a Government call to action and WHO’s Clean Care Is Safe Care campaign.

It was about clearly demonstrating what had been happening in terms of infection prevention and what needed to be improved

She told the conference: “In Scotland there were two big drivers for change – coming both nationally and internationally. It was about clearly demonstrating what had been happening in terms of infection prevention and what needed to be improved.

“A multi-faceted approach was absolutely critical and we needed to have all health boards working together.”

Studies were carried out on trends across the country relating to outbreaks and incidents of MRSA, with researchers looking at existing guidance as well as issues such as antibiotic prescribing, improvement tools, monitoring, education and training, and targets.

This information was collected across all health boards so a picture of the entire country could be created.

Kilpatrick said: “Information on just one organisation in isolation, or from one ward or one hospital, would not have had the same effect and would not have given us the information we needed.

“It is very challenging, but we had a very co-ordinated Government driving this effort and as a result the programme has had a really measurable impact.”

Figures show the overall incidence rate of bloodstream infections decreased by 12.3% in 2011, with MRSA accounting for 13.6% of cases.

And Kilpatrick said that, despite falling prevalence in England as well, co-ordination between health trusts was much less common. Much of this is down to the larger size of the country, but also, she said, due to the diversity of trusts in different parts of England.

“Information on just one organisation in isolation, or from one ward or one hospital, would not have had the same effect and would not have given us the information we needed

“While Scotland might be smaller in size, there are very rural areas and it is challenging. But it was important that this was a central government-led project.

“It will be harder in England, but we have found there are definite advantages to this kind of joined-up approach to the issue of infection control and prevention.”

Key findings to come from the Scottish project include a need to carry out regular evaluation and provide feedback that is reliable and delivered at the right time, a need for better education and training to help drive the necessary culture change needed, and innovative ways of raising awareness.

Commenting on its successful approach earlier this year, Professor Jacqui Reilly, lead consultant for healthcare acquired infections at Health Protection Scotland, said: "We are making real progress in the fight against infections in Scotland and our surveillance systems are invaluable in helping to drive improvements. Surveillance helps us focus our efforts on the most important areas for prevention and control of these complex infections and we will continue to strive to reduce levels wherever possible."

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