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Hospitals: Infections

Volume 491: debated on Wednesday 22 April 2009

To ask the Secretary of State for Health (1) how many patients were screened for healthcare-acquired infections in (a) the North West and (b) England in each of the last five years; and if he will make a statement; (269148)

(2) how many patients were treated for healthcare-acquired infections in (a) the North West and (b) England in each of the last five years; and if he will make a statement.

Data on screening for health care associated infections are not collected centrally. The information requested on treatment is not collected centrally. The best available data are from the mandatory surveillance system, which covers methicillin-resistant Staphylococcus aureus (MRSA) bloodstream infections, Clostridium difficile infections, glycopeptide-resistant enterococci bloodstream infections, and orthopaedic surgical site infections operated for the Department by the Health Protection Agency (HPA).

Data for England and North West of England respectively are provided in the following tables. Regional data are not available for surgical site infections.

Since April 2001, all acute national health service trusts in England have been obliged to report all cases of bloodstream infections caused by MRSA. These data comprise all specimens processed by NHS acute trust laboratories, not just those from in-patients and include infections acquired in hospital and elsewhere. These data are only available by financial year.

Number of cases of bloodstream infections caused by MRSA

Number of cases of bloodstream infections caused by MRSA

April to March each year

England

North West England

2003-04

7,700

975

2004-05

7,233

1,016

2005-06

7,096

1,031

2006-07

6,383

936

2007-08

4,448

670

All acute NHS trusts in England are obliged to report all cases of Clostridium difficile (C. difficile) infection in people aged 65 years and over since January 2004. These data comprise all specimens processed by NHS acute trust laboratories, not just those from in-patients and include infections acquired in hospital and elsewhere.

Number of cases of C. difficile infection in people aged 65 years and over

Number of cases of C. difficile infection in people aged 65 years or over

England

North West England

2004

44,563

5,460

2005

51,829

6,513

2006

55,635

7,441

2007

50,461

8,436

Since October 2003, all acute NHS trusts in England are obliged to report all cases of blood stream infections caused by glycopeptide resistant enterococci. These data comprise all specimens processed by NHS acute trust laboratories, not just those from in-patients and include infections acquired in hospital and elsewhere. These data are available from October to September; they are not available by calendar year.

Number of cases of blood stream infections caused by glycopeptide-resistant enterococci

Number of cases of bloodstream infections caused by glycopeptide-resistant enterococci

October to September each year

England

North West England

2003-04

628

59

2004-05

757

113

2005-06

903

130

2006-07

910

114

Since April 2004, the following data have been collected from the mandatory surveillance of surgical site infections (SSIs) in orthopaedic categories in English NHS hospitals. Hospitals carrying out orthopaedic surgery have to participate in the surveillance of at least one category for at least one quarter of the year. All of the SSIs reported are identified during the in-patient period.

2004-052005-062006-072007-08

Surgical category

No. of operations

No. of SSIs

No. of operations

No. of SSIs

No. of operations

No. of SSIs

No. of operations

No. of SSIs

Hip prosthesis

16,765

211

21,046

190

25,397

181

28,510

145

Knee prosthesis

15,848

103

22,843

128

25,167

96

30,605

87

Open reduction of long bone fracture

3,277

66

2,774

44

3,678

69

3,752

35

Hip hemiarthroplasty

5,396

219

6,328

230

6,709

211

6,333

151

To ask the Secretary of State for Health what estimate he has made of the cost of treating cases of (a) clostridium difficile and (b) other healthcare-acquired infections in each of the last five years; and if he will make a statement. (269150)

The Department of Health does not routinely collect this information and no single definitive cost figure exists. However, a study by the Public Health Laboratory Service (PHLS) in 1999 estimated that Healthcare Associated Infections (HCAIs) cost the national health service £1 billion a year. This remains the best available estimate of NHS costs.

To ask the Secretary of State for Health how many legal actions have been taken against NHS trusts by the families of patients whose deaths were caused by (a) clostridium difficile and (b) other superbug infections in each of the last five years; and if he will make a statement. (269828)

The NHS Litigation Authority (NHSLA) cannot run a report on its database to identify claims relating to cause of death. This answer could therefore be obtained only at disproportionate cost.

However, the NHSLA does record on its claims database:

whether the claimant is the a family member;

an injury being a health care associated infection; and

the cause, such as failed infection control policy or hospital hygiene.

The NHSLA have supplied this information in the following table.

Number of claims received 2004-05 to 2008-09 where the claim is made by a family member1, the injury is a health care associated infection, and the cause is failed infection control policy/hospital hygiene as at 31 March 2009 split between Clostridium difficile and other superbug infections

NHSLA notification year

Claim status

Clostridium difficile

Other superbug

2004-05

Incident

Open

Closed—nil damages

6

Settled—damages paid

1

Total

7

2005-06

Incident

Open

Closed—nil damages

3

Settled—damages paid

1

Total

4

2006-07

Incident

1

Open

2

3

Closed—nil damages

4

11

Settled—damages paid

3

2

Total

9

17

2007-08

Incident

1

Open

13

4

Closed—nil damages

6

6

Settled—damages paid

7

3

Total

27

13

2008-09

Incident

5

1

Open

20

8

Closed—nil damages

6

1

Settled—damages paid

2

Total

33

10

Total

69

51

1 Claims brought by a family member are likely to indicate that the patient died, although some may be on behalf of patients that lack the requisite mental capacity to make a claim.

To ask the Secretary of State for Health how many NHS trusts have admitted liability for patient deaths caused by (a) clostridium difficile and (b) other superbug infections in each of the last five years; and if he will make a statement. (269829)

The NHS Litigation Authority cannot run a report on its database to identify claims relating to admissions of liability for patient deaths. This answer could therefore be obtained only at disproportionate cost.

To ask the Secretary of State for Health what recent assessment he has made of the effectiveness of mandatory screening for (a) clostridium difficile and (b) other superbug infections. (269830)

The available evidence does not suggest that screening of patients without symptoms of intestinal infection for Clostridium difficile would be clinically effective, as patients without symptoms are not considered to present an increased risk of infecting others. As set out in current guidance, all those aged 65 years or over in hospital with diarrhoea should be tested for C. difficile and other patients tested as clinically indicated. This will ensure the infection is identified quickly and appropriate measures are taken to treat the patient and minimise infection of other patients.

From 1 April 2009, the national health service has been screening all relevant patients for methicillin-resistant Staphylococcus aureus (MRSA) before planned operations. This will help the NHS reduce the chances of patients getting an MRSA infection, or passing MRSA onto another patient but it is too early to assess the efficacy of screening. There are no other national screening programmes for health care associated infections.