NHS Hospitals Disgrace- Ten Times the Super Bug Death Rate than Any Other Country
Politics / NHS Apr 29, 2008 - 02:24 AM GMTBy: BBC
Panorama: How Safe Is Your Hospital? BBC One 's Panorama reveals that there are 10 times more deaths across the UK from the superbug clostridium difficile among over 65-year-olds than in any other country in the world.
The equivalent of one person dies every hour in our hospitals from this deadly superbug. It contributes to the deaths of four times as many people as MRSA.
In addition, it is mutating, getting even stronger and showing signs of resistance to one of only two drugs able to combat it.
These shocking findings are revealed in a Panorama special, Panorama: How Safe Is Your Hospital? on Sunday 27 April 2008 at 10.15pm on BBC One (online http://www.bbc.co.uk/iplayer)
It was announced this week that c.diff infections in England fell by 8% between October and December 2007.
However, Panorama has learned that the way cases are counted has changed, and experts calculate that the real figure is actually between 16% and 35% higher than this – making a substantial increase on the last quarter.
In Scotland, too, the number of cases went up by 10% and in Northern Ireland there was a hefty rise of almost 36%.
Comparable figures for Wales are not out yet.
The UK as a whole remains bottom of the world league.
Professor Richard James , who runs a leading centre in Nottingham University to investigate hospital infections, told Panorama: "The figures for c.diff show that more than 50% of hospital trusts in the UK have a rate of infection that's more than 10 times that of any other country.
"If you look at the over 65s, which are the group where there are more deaths, then we have more cases there, and therefore more deaths in that age group, than any country in the world by a factor of 10."
His remarks are based on a draft report to the Department of Health from the influential steering group on healthcare-associated infection, which is currently out for consultation.
This draft report can be downloaded from the Health Protection Agency website.
While the figures are based on English acute NHS trusts, Professor James says they are relevant to the whole of the UK.
In the programme he agrees that this is "an extraordinarily bad situation".
Professor Brendan Wren , of the London School of Hygiene and Tropical Medicine, tells Panorama: "The deaths of 6,500 people a year is the equivalent of one person dying every hour in our hospitals."
Panorama has carried out a Freedom of Information survey of every acute trust and health board in the UK, to which 83% of trusts replied.
Of the 170 who replied, a majority of 95 trusts had bed occupancy rates of more than 85%.
Professor James says: "Experts would say if you go above 85% bed occupancy rates then that is not conducive to good control of infection measures."
The survey also reveals that 94% of hospitals now have alcohol hand gels outside their infection wards – which is effective for MRSA.
However, alcohol hand gels do not work against c.diff. In fact, according to Professor Wren, they make it worse.
He says: "In the laboratory, if we want the organism to form spores we treat them with alcohol, we alcohol-shock them. So the use of alcohol wipes in hospitals should probably be stopped for clostridium difficile."
Hand-washing is the safest way of protecting against c.difficile.
Among the most serious concerns of scientists is that the superbug itself is mutating and strengthening.
Only two antibiotics, Vancomycin and Metronidazole, can treat clostridium difficile.
Recent research by Professor Mark Wilcox , Professor of Medical Microbiology in the Leeds Teaching Hospitals Trust, has revealed partial resistance to Metronidazole.
He says: "It really isn't a good scenario when you're dealing with so many cases and have a single antibiotic."
The Department of Health has put £270m into a new initiative within hospitals, and £57m towards deep cleaning.
Professor Wren says: "If a fraction of that could be put into research then we could potentially have a better long-term solution for eradicating clostridium difficile."
To illustrate what happens when hospitals get infection control wrong, the programme was given unprecedented access to the Maidstone and Tunbridge Wells Trust in Kent, where around 90 patients died in two outbreaks of c.difficile in 2005-6, with more than 1,100 people infected.
The Trust is now under new management.
One of the patients who died in the second outbreak there was 83-year-old Mary Hirst , who was admitted to Maidstone Hospital on 8 April after a fall. An operation on her hip was a success, but she caught c.difficile on the ward.
When her daughters Carol Higgins and Jackie Stewart went to visit Mary, they were appalled to find her covered in her own excrement.
Her daughter Jackie told Panorama: "She was just laying there sobbing with a mess all up her hands, up her arms, down her front. And she told me, Jackie, look at the state of me. She said, nobody's cleaned me up. She said I've made a mess and I'm so embarrassed."
Carol and Jackie claimed that people were dying around their mother all the time.
Carol said: "We actually joked that they might have a deal with the undertaker because we actually saw so many bodies going out."
Notes:
These latest figures do not include recurrences. The recurrence rate is thought to raise the overall rate by 20 to 25%.
Panorama: How Safe Is Your Hospital?, Sunday 27 April 2008, 10.15pm, BBC One, and online http://www.bbc.co.uk/iplayer
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