Worst NHS trusts for hygiene threatened with fines and closure by super regulator

The worst NHS organisations for hygiene standards have been named and shamed by a new super regulator and threatened with fines and even closures if they do not improve.

In a first show of strength, the new Care Quality Commission has named 21 organisations which are failing to take sufficient action to prevent superbugs like MRSA and C. difficile.

The list contains eight trusts where there are high infection rates, persistent problems or a potential risk to patients has been identified. They will face further inspections by the regulator.

All the failing trusts have been warned they must improve within set deadlines or face further sanctions including warning notices, fines, and the possibility of wards or units being closed down.

Problems found included inadequate cleaning of ambulances, poor antibiotic prescribing practice, delays in isolating infected patients, lack of supervision of cleaning and infection control staff, dirty surgical equipment, lack of reporting of infection control measures to board level, delays in receiving laboratory test results and poor standards of cleanliness on wards.

All healthcare providers, except GP and dental surgeries, must be registered with the Care Quality Commission by 2010, in what is in effect a ‘licence to practice’, and the first step has been to register compliance on infection control measures.

All 388 NHS organisations that provide direct care to patients have been registered but the 21 trusts judged to be failing have been given conditional registration.

Barbara Young, chairman of the CQC, said: “Most trusts have stronger systems to protect patients from infection than a few years ago, and trusts’ boards are taking the challenges seriously. We commend them for that.

“In 21 trusts we need further assurance that they are meeting the regulations. We have placed rigorous conditions on these trusts’ registration and will monitor them closely.

“While infection rates at these trusts are not necessarily higher, they can do more to strengthen their approaches to infection control and help prevent outbreaks. We will monitor their performance throughout the year and will not hesitate to use our enforcement powers to protect patients’ safety where needed.

“This is only the beginning of our work with NHS trusts. We aim to ensure they strive for continued improvement and that patients receive the same consistently high service wherever they receive care.”

In eight cases, the trust failed to achieve required standards for infection control on repeated occasions and/or had a high infection rate and/or a potential risk to patients’ safety was found on inspection.

The eight trusts are: Barnet, Enfield And Haringey Mental Health NHS Trust, Barts And The London NHS Trust, Kettering General Hospital NHS Foundation Trust, Leeds Teaching Hospitals NHS Trust, North Bristol NHS Trust, Plymouth Hospitals NHS Trust, South West London And St George’s Mental Health NHS Trust, United Lincolnshire Hospitals NHS Trust.

Registration on healthcare associated infection is the first step towards full registration on all basic standards, a regime that will come into force from April 2010.

For the first time the regulator has the power to impose fines of £4,000 on the spot and up to £50,000 through the courts. The Care Quality Commission also has the power to close wards, services or a whole hospital in extreme circumstances.


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