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Clostridium Difficile

Volume 464: debated on Monday 15 October 2007

The Healthcare Commission (HCC) published a report on 11 October 2007 titled “Report of the investigation following outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells NHS Trust” following their investigation into Clostridium difficile.

The HCC commissioned its investigation into the trust following a request by the then Kent and Medway Strategic Health Authority following concerns that there had been a significant increase in the numbers of Clostridium difficile at the trust. The report has been placed in the Library.

There were two outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells Hospitals NHS Trust between April 2004 and September 2006. The findings of the report show that there were 1,176 patients with Clostridium difficile at the trust between April 2004 and September 2006, of whom at least 345 died.

The report estimates that if the 50 cases that were reviewed as part of the HCC's investigation were representative of the 345 who died, and the reviewer's assessments are extrapolated to all, of the 345 deaths, Clostridium difficile was probably or definitely the main cause of death in approximately 90 patients, and definitely the cause in 21 cases.

The report calls for immediate changes to improve the care of patients and control of infection at the trust, which I fully support. The report has exposed significant failings in the duty of care at the trust, which I do not expect to see replicated elsewhere in the country. The HCC is continuing to work with the trust and NHS South East Coast to ensure an appropriate action plan is agreed and implemented.

Following the recommendation of the Health Care Commission Report, the South East Coast Strategic Health Authority have commissioned an independent review into the leadership of the trust during the period of the outbreaks. This will be carried out by an independent consultancy with experience in this area, and an interim report will be made available to the strategic health authority by November.

In addition to this, I have asked the Department to carry out a separate review into the role of the Chair of the trust and the decision-making process that led to the terms and conditions of the Chief Executive's departure. This will conclude urgently, will be shared with the Appointments Commission and will inform what action is taken with regard to the position of the Chair.

This is an alarming and distressing case and the trust and the Department has offered its sincere condolences to the patients and families who have been affected by these outbreaks

In line with national guidelines, trusts should deliver, clean, safe treatment for every patient in their care, every time. Where senior management and trust boards fail to act to deliver this expected standard they must and will be held accountable.

In addition, the NHS Chief Executive will write personally to every NHS trust appending a copy of the Healthcare Commission's report and seek reassurances from every Chief Executive in the country that the drive to improve infection control is a major priority in every organisation.

Although employment is a matter for the local NHS trust board, I have instructed the trust in this exceptional case to withhold any severance payment to the former chief executive of Maidstone and Tunbridge Wells NHS Trust, pending legal advice.