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Superbug tests for all patients
Sophie Goodchild and Amy Iggulden, Evening Standard4 Oct 2007
Every patient will be screened for superbugs for the first time under government plans revealed today.
Nurses will swab anyone admitted to hospital to test for life-threatening infections such as MRSA.
Those with positive results will be placed in isolation and given creams and body washes to clear the bugs.
The proposal is part of the Government's "once in a generation" nationwide review to improve the NHS. It is published today in an interim report by Lord Darzi, the minister responsible for patient care. Professor Sir Ara Darzi - a pioneer in robot-assisted surgery - was due to release the review in a fortnight. But the date was brought forward amid election speculation.
In an interview with the Evening Standard, Lord Darzi said full screening is aimed to halve the rate of MRSA infection. Lord Darzi, who has also drawn up a blueprint to overhaul the NHS in London, said: "We need a better ethos in hospitals on preventing infection, not just with doctors but with all staff including the porters and visitors."
The Prime Minister has already ordered hospitals to carry out "deep cleaning" once a year, banned doctors' white coats and given matrons more powers to report to boards.
Health Secretary Alan Johnson also unveiled plans at the Labour conference to give the new super-regulator Ofcare powers to fine hospitals that fail to tackle superbugs and close dirty wards.
But the "deep clean" proposal has been savaged by specialists.
The Lancet, a leading medical journal, said that the only way to beat infection was through hand-washing.
Under the new plans, doctors will take samples from the armpits and noses of patients as soon as they come into hospital with results back in hours. Those infected will be put into isolation and given special creams and body-washes before surgeons can operate. Anti-bacterial gel dispensers will also be placed in every patient cubicle.
Lord Darzi said: "Cleanliness is not just about wards being clean. It's about preventing the spread of infection. I wash my hands for at least five minutes before I carry out an operation. I tell patients not to let anyone touch them unless they have washed their hands."
Q&A
Why should every patient be screened?
Deadly bugs such as MRSA are thought to kill more than 5,000 people a year. Rates fell by 17 per cent in the last year but the bug is still a major problem. Almost five per cent of patients admitted to University College Hospital, for example, have the infection and it spreads within three days - the current time to get results from a screening test - through human contact or contaminated equipment. A quicker, automatic test would give hospitals crucial time to prevent this happening.
How would it be done?
A swab would be taken from the nose and armpit and a sample sent to an in-hospital lab with results in four hours.
What is being done already?
Many hospitals are already screening high-risk patients such as those in intensive care, but only one hospital is believed to be testing all admitted adults as routine - Darent Valley in Kent. UCH is already using the quick test for high-risk groups.
Can it be done?
The quick test would be far more expensive than the standard three-day test - up to £20 compared with only a few pounds. Managers will have to be convinced it will prove cheaper than treating MRSA in the long-term. Each MRSA case costs a hospital £4,200 but body-wash treatments cost under £8
What about C.difficile?
The test for this potentially fatal stomach bug is already very quick but is only carried out on patients showing symptoms of diarrhoea. Experts say automatic screening would be of no use, because patients who are not ill or showing symptoms pose no threat of cross-contamination.
