The Purchasing and Supply Chain undertook an assessment of the effectiveness of alcohol-based hand rubs in 2004 prior to awarding their national contract. All products supplied under the NHS contract are effective for use at the point of care in most situations. However, guidance makes it clear that liquid soap and water should be used during Clostridium difficile outbreaks as hand rubs will not eradicate Clostridium difficile spores.
Under “The Health and Social Care Act 2008 Code of Practice for the NHS on the prevention and control of healthcare associated infections and related guidance”, there is an obligation for national health service, bodies to ensure that all staff are suitably educated in the prevention and control of healthcare associated Infections. A copy of this code of practice has been placed in the Library.
Training is a local decision, and we do not collect the information requested. However, BMJ Learning, in association with the Department, produced an e-learning module to learn practical ways to avoid an outbreak of Clostridium difficile. This is available at
The Department is not directly funding research to develop vaccines for Clostridium difficile infections. However, the Health Protection Agency is working with Acambis, a UK based company, through the Department’s funded National Vaccine Evaluation Consortium to support clinical trials of a vaccine against Clostridium difficile.
The Medical Research Council (MRC) is one of the main agencies through which the Government support medical and clinical research. The MRC is an independent body that receives its grant-in-aid from the Department for Innovation, Universities and Skills.
MRC spend on research into health care associated infections, including Clostridium difficile, over the last five years is shown as follows:
Expenditure (£ million) 2003-04 0.8 2004-05 1.7 2005-06 2 2006-07 2.5 2007-08 3.7
Expenditure (£ million)
Clostridium difficile projects currently being funded by the MRC include:
Understanding the relationship between bacteriophages and pathogenicity in the gut pathogen Clostridium difficile, led by Dr. M Clokie at the university of Leicester (awarded £350,000);
Structural and functional characterisation of cell wall proteins of Clostridium difficile, led by Professor R Titball at Imperial College of Science Technology and Medicine (awarded £1.4 million);
The I-STRAT trial: Do Isolation Strategies reduce endemic levels of Methicillin-resistant Staphylococcus aureus and Clostridium difficile associated diarrhoea, led by Dr. S Stone at University College London (awarded £420,000); and
Understanding the molecular basis of virulence in Clostridium difficile, led by Professor N Minton at the university of Nottingham (awarded £1.6 million).
The Department’s policy research programme is currently supporting a research project on the environmental survival and antimicrobial resistance of pathogens (including Clostridium difficile) in hospitals. Expenditure on the project in 2007-08 was £15,000.
The National Patient Safety Agency has run the ‘Cleanyourhands’ campaign focussed on hand hygiene in hospitals since 2004, broadening its focus in 2008 to primary care ambulance and mental health trusts. Currently over 90 per cent. of national health service trusts are signed up to the campaign. In addition, the Department has run a campaign on antibiotic awareness and participated in European antibiotic awareness days. The correct use of antibiotics and hand hygiene represent two important areas in tackling Clostridium difficile and other health care associated infections.
We have not run any specific campaigns to raise public awareness of Clostridium difficile or other health care associated infections in the last five calendar years.
The national health service, in order to meet its legal requirements under ‘The Code of Practice of the Prevention and Control of Healthcare Associated Infections’ (HCAI) must provide suitable and sufficient information on HCAI to the patient, the public and other service providers when patients move to the care of another health care or social care provider.
NHS trusts will provide this information locally and we do not hold details centrally.