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Health: C. Difficile

Volume 697: debated on Monday 17 December 2007

asked Her Majesty's Government:

Further to the Written Answer by Lord Darzi of Denham on 29 October (WA 15) on deaths caused by infecting National Health Service patients with Clostridium difficile, what action was considered or taken by Health Ministers, either during the period covered by the answer or subsequently, against any of the primary care trusts with the highest number of infections. [HL30]

The department has issued a wide range of guidance and best practice to support local health communities in improving the control and management of infections such as Clostridium difficile infection (CDI). This includes:

mandatory surveillance of CDI introduced in 2004 to help to establish the extent of the problem;

the Health Act 2006: Code of practice for the prevention and control of healthcare associated infections came into force on 1 October 2006 and requires National Health Service bodies to have appropriate management and clinical governance systems in place to deliver effective infection control. The Healthcare Commission assesses trusts against the code and can issue improvement notices, requiring that failures are remedied where it finds that the code is not being observed in any material respect;

Saving Lives: a delivery programme to reduce healthcare associated infections included an updated high impact intervention on CDI and antimicrobial prescribing a summary of good practice, which is particularly relevant for managing CDI; and

the introduction of a new “bare below the elbows” uniform code for NHS staff.

The NHS has been performance-managed at an individual organisational level against the original methicillin resistant Staphylococcus aureus (MRSA) target, to halve the number of MRSA bloodstream infections by April 2008. Many measures which tackle MRSA will also affect other healthcare associated infection (HCAI) rates.

In order to increase the focus on tackling CDI, we have now set new requirements for the period to 2010-11 under the new Better Care for All Public Service Agreement, to deliver a 30 per cent reduction by 2010-11 in CDI compared with the numbers in 2007-08. This will be performance-managed at an individual organisational level through local delivery plans.

The department’s HCAI improvement teams offer tailored support to individual trusts. We have doubled the funding for the HCAI improvement teams this year and expanded their remit so the teams are now providing support to those trusts that have high numbers of patients with CDI as well as those with the most challenging MRSA targets. The improvement teams have already worked with 146 trusts.