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Volume 487: debated on Tuesday 10 February 2009

To ask the Secretary of State for Health what assessment he has made of the effectiveness of his Department’s Clean Safe Care strategy for reducing MRSA infections and deaths. (254964)

The “Clean, safe care” strategy was published in January 2008, and gave an overview of our strategy and initiatives, many of which were already well established, to tackle health care associated infections (HCAIs) and improve cleanliness. A copy of the strategy has already been placed in the Library.

We have significantly reduced meticillin-resistant Staphylococcus aureus (MRSA) infections. The latest Health Protection Agency data for July to September 2008 show a reduction in MRSA bloodstream infections of 33 per cent. compared to the same quarter in 2007. In 2008, the national health service met the nationwide target to halve the number of MRSA bloodstream infections compared to 2003-04 levels. Latest figures also show a 62 per cent. reduction compared to the quarterly average in 2003-04, making further progress.

The number of death certificates that mentioned MRSA decreased by 4 per cent. from 1,652 in 2006 to 1,593 in 2007. This is the first time the number of death certificates mentioning MRSA has fallen since ONS records began in 1993.

The following table details the number of death certificates with MRSA mentioned and MRSA as the underlying cause, England and Wales, 2003-07.

Number of death certificates in England and Wales






Mentions of MRSA






Number of these where underlying cause of death is MRSA







ONS Health Statistics Quarterly.

Many patients who become infected with a HCAI have other serious and potentially fatal underlying medical conditions. Doctors are not supposed to record all diseases or conditions present at death, only those that contribute directly to it. It is a matter of individual professional judgment whether the doctor lists an HCAI as a contributory cause. There have been a number of initiatives to raise the profile of HCAIs and improve their acknowledgment as diagnoses in their own right. In October 2007 and July 2005 the chief medical officer reminded doctors of the importance of giving full and accurate information on the death certificate, particularly in relation to HCAIs.

We have commissioned an evaluation of the effectiveness the HCAI and Cleanliness Improvement Programme (one strand of the “Clean, safe care” strategy) with a specific focus on the work streams focused on reductions in the incidence of MRSA. We are also commissioning work to understand the ways in which hospital cleanliness relates to other aspects of a good environment, and how this might have an impact on HCAIs. These studies are in their initial stages and will provide results later in 2009.

To ask the Secretary of State for Health what estimate he has made of the number of NHS clinical staff who are carriers of MRSA. (254965)