Hospital flies in a hygiene expert from the US to tell doctors to wash their hands

It came after fears that senior medics at University College Hospital were not taking hygiene seriously.

Specialist infection nurses invited Dennis Maki, from the University of Wisconsin, to try to force senior staff to pay more attention to superbugs.

Annette Jeanes, director of infection prevention and control, said doctors were not listening to nurses' advice.

"We're teaching cleaners to wash their hands and they say, 'That's interesting, why don't you teach the doctors?' I spend a lot of time teaching doctors to wash their hands but they are not that interested. They think they save lives and that's enough."

She said Dr Maki's trip had been funded by a firm that makes infection-killing products.

Ms Jeanes said: "The doctors came in droves. They ate the food, came to see the guru and listened. If they don't listen to their own experts we'll get someone they will listen to."

The event was arranged after Mrs Jeanes found that doctors were more likely to listen to an "international expert" than nursing staff. She said: "I can talk to nurses okay and the message gets through. But we need to get doctors on board. They are taking it seriously now, they just didn't realise."

She told a patients' forum in Camden that it was one of a string of problems that hygiene bosses are trying to overcome, including:

Patients not following basic hygiene.

High bed occupancy rates making cleaning difficult.

Staff refusing to clean commodes.

Not enough isolation facilities for patients who catch superbugs.

The introduction of 18-week targets for operations and paymentby-results - where hospitals get paid only for the work they do - had also caused problems, Ms Jeanes said. "The effect on the hospital has been enormous because we have to meet these targets. Operations are going through faster but that doesn't come without a cost in infection control."

Her comments come amid a national crackdown on hygiene in an effort to combat rising rates of the stomach bug C. difficile. Cases of the superbug MRSA are falling year on year but the Government is expected to miss its target of halving the number by 2008.

University College London Hospitals NHS Foundation Trust called in Dr Maki after his research discovered that intravenous lines - where patients receive drugs in a vein - are responsible for most cases of the superbug MRSA.

The trust now has a hygiene control system based on his research and recorded no cases of MRSA for the first time in June. It was the first trust in the country to introduce flat keyboards and rapid screening for new patients.

However, Mrs Jeanes said a new training system for junior doctors, poor patient hygiene and government targets had caused problems. "It is the hygiene of some patients that is frankly a problem. We have to prompt them to wash their hands after going to the lavatory," she said.

A spokesman for the trust said: "We will be giving additional training to domestic cleaning staff to make sure that they clean effectively around beds."

A BMA spokesman added: "Health professionals, patients and visitors all have a role to play in reducing hospital acquired infections."