Page last updated at 09:05 GMT, Tuesday, 9 June 2009 10:05 UK

Infection drive 'hit by targets'

Hospital cleaning
Rates of MRSA infection have come down

Doctors say efforts to tackle healthcare associated infections are being undermined by government policy.

A British Medical Association report says infection control practices have been damaged by overcrowding and understaffing in NHS facilities.

It also says there has been an over-reliance in England on short-term solutions such as deep cleaning, dress code policies and alcohol hand gels.

Government officials said its policies had successfully cut infection rates.

Reduce bed occupancy rates
Ensure adequate staffing to match workload
Adequate resources for thorough, everyday cleaning, with emphasis on cleaning high-risk near-patient hand-touch sites
Introduction of evidence-based screening policies
Use of protective clothing based on hard evidence
Hand hygiene drive backed by awareness campaigns, and improved access to hand washing facilities
Strategies to improve use of antimicrobial drugs

The risk of contracting a healthcare associated infections (HCAIs) has been fuelled in recent years by advances in medical technology, which have enabled successful treatment of more seriously ill patients - who are vulnerable to infection.

The threat has also been compounded by rising rates of drug resistance among infection-causing bugs.

The Department of Health in England has estimated that up to 30% of HCAIs are preventable, and has introduced a range of measures to combat them.

This has resulted in a drop in levels of infections caused by the superbug MRSA.

Patient throughput

However, the BMA says these efforts have been undermined by polices promoting higher patient throughput, which has led to many services constantly operating close to full capacity.

This has led to overcrowding, understaffing, higher bed occupancy, and increased movement of patients between hospital wards.

All of these factors have made it difficult to implement measures such as hand washing, and screening of at-risk patients.

The report says: "It is essential that the drive for increased efficiency and economic rationalisation does not compromise patient safety."

The report also warns that there is little evidence to prove the effectiveness of current strategies to reduce infection, many of which are too short-term.

It says more research should be a top priority, so that an effective long-term strategy can be formulated to produce lasting results.

Dr Jonathan Fielden, chairman of the BMA's Consultants' Committee, said: "Hygiene, hand-washing and antibiotic policies, have extremely important roles to play but if we want to reduce the spread of infections we must put safety in front of political targets.

"The pressure to turn around patients too quickly and the lack of adequate isolation facilities create critical challenges to maintaining high quality patient care."

Ann Keen, health minister for England, said: "Latest figures clearly show that MRSA infections have fallen by over 65% and C. difficile infections are down by over 35% - so it is difficult to understand the BMA's suggestion that our broad integrated strategy to reduce healthcare associated infection has been anything other than a success.

"We have already introduced long term evidence-based solutions in the Hygiene Code which came into force in 2006 and sets out the legal NHS requirements for the prevention and control of Healthcare Associated infections.

"However, we accept that one preventable infection is one too many and we continue to battle against infections on every front."

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