(2) what research her Department has (a) commissioned and (b) examined on the possibility of (i) MRSA and (ii) clostridium difficile being airborne infections.
The main agency through which the Government support biomedical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Innovation.
The MRC funds a considerable programme of research that underpins scientific understanding of hospital-acquired infections including methicillin-resistant staphylococcus aureus (MRSA), clostridium difficile and other antibiotic resistant pathogens. A summary of the financial support given as part of that programme specifically to research on MRSA is shown in the table.
£ million 2000-01 0.8 2001-02 1.4 2002-03 1.4 2003-04 0.7 2004-05 0.9 Total 5.2
In addition, the MRC also currently supports two PhD studentships on the pathogenesis and immune response to clostridium difficile.
The Department has recognised the public health importance of rising antimicrobial resistance for many years. During the first half of 2003 the Department commissioned a £2.5 million strategic programme of research aimed at improving scientific understanding of antimicrobial resistance. £590,000 of that total sum was spent between 2004 and 2006 supporting three research projects specifically dealing with MRSA.
The publication of the Department's report “Winning Ways—working together to reduce healthcare associated infection in England” in December 2003 was accompanied by the announcement that £3 million would be allocated to fund a new research programme on healthcare associated infections.
Of the projects now being supported by this fund, two are specifically related to MRSA:
a study of the efficacy and cost-effectiveness of MRSA screening and monitoring on surgical wards using a new molecular test; and
a randomised crossover trial of a new, rapid method of MRSA detection compared with conventional screening, looking at efficacy and the effect upon hospital MRSA infection rates, transmission rates and the use of hospital resources.
Some £900,000 is being provided to support these two projects.
The Department is also supporting a £90,000 study related to improving understanding of possible community-acquired MRSA; has funded a national confidential study of suspected deaths from healthcare-associated infection at a cost of £254,000; and a £216,000 study of bacteraemia in children caused by MRSA.
The Department is not sponsoring research specifically focused on airborne transmission of hospital-acquired infections.
Tackling MRSA is a priority for Government and the national health service. We have set a target to halve the number of MRSA bloodstream infections by 2008 and each acute trust has its own target. The Department and its partner organisations have developed a range of mutually reinforcing activities that ensure combating the spread of MRSA is embedded in everyday procedures and policies, in particular:
all acute trusts are signed-up to the ’Saving Lives’ package of best practice which, if implemented in full, should combat MRSA spread in the acute sector. It is supplemented by the ’Essential Steps’ initiative, designed for non-acute care settings;
mandatory MRSA surveillance, which continues to be developed/enhanced;
the first ever national hand hygiene programme for hospital staff ‘cleanyourhands’, has progressed to its second year;
a root cause analysis tool was published in September 2006 to help trusts investigate and better understand how and why MRSA bloodstream infections occur and hence where they should focus their action to prevent them;
a statutory code of practice which requires NHS bodies to have appropriate management and clinical governance systems in place to deliver effective infection control came into force on 1 October;
enhanced advice on screening patients at risk was published on 16 November; and
acute trusts have been invited to apply for additional capital resources to help tackle healthcare associated infections, with £50 million set aside for this purpose.
Additionally, tailored support is available for those trusts in the most challenging positions. Improvement teams will during 2006-07, work with about 50 trusts, so as to help identify those issues that prevent reduction in infections at the local level, and help them develop action plans to speed up and sustain progress.