By Nick Triggle
Health reporter, BBC News
MRSA rates are falling, according to latest figures
A small group of NHS trusts is potentially putting patients at risk because of poor infection control, the new health super regulator says.
The Care Quality Commission identified 21 trusts in England which were not doing enough in areas such as cleanliness and decontamination.
The regulator said if the group did not improve they would face tough measures such as fines and closure of services.
But the government pointed out that overall infection rates were falling.
The target to halve MRSA infections was met last year and latest figures show that Clostridium difficile rates are also falling.
Nonetheless, the regulator, which was only created this week following the merger of three bodies, has made infections one of its key priorities.
One of the new measures it has brought in has been a system of registration, which means NHS trusts have to meet certain criteria to even be registered with the regulator.
In the first year this only applies to infection control, but from next April it will be extended to other areas.
The CQC assessed all 388 trusts, covering hospitals, mental health units, ambulances and primary care trusts which run community services, against hygiene standards and cross-checked these with surveys and previous inspection reports.
The regulator has registered all the trusts, but attached conditions demanding improvements be made over the coming weeks and months in the 21 cases.
Of those 21 trusts, 13 had declared they did not meet some of the CQC's registration criteria.
The regulator also highlighted eight where progress in tackling the problems was said to be slow.
CQC chairman Barbara Young said: "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."
A Department of Health spokesman said it was important to recognise that the NHS was getting better over infections.
But he added: "We expect those trusts to rapidly improve the safety of the services provided and deliver a high quality of care as expected by all patients."
Joyce Robins, of Patient Concern, said: "I am not surprised by this. Yes, infection rates are coming down, but it was from a very high base.
"Too many hospitals are not taking this seriously enough and it is having horrific results for patients."
Averil Dongworth is chief executive of Barnet and Chase Farm Hospitals NHS Trust, which saw one of its hospitals, Chase Farm, receive an improvement notice two years ago.
She said: "What I have said to staff on many occasions, and they agree, it was the worst thing that happened to us, it was the best thing that happened to us, and we have gone further, faster and deeper in changing the quality of our services in this hospital because of it."
• The eight trusts which were responding slowly were: Barnet, Enfield and Haringey Mental Health, Barts and the London, Leeds Teaching Hospitals, Kettering General, North Bristol, Plymouth Hospitals, South West London and St George's Mental Health, United Lincolnshire Hospitals.
• The 13 other trusts highlighted were: Alder Hey, Barking, Havering and Redbridge, Coventry and Warwickshire Partnership Trust, Herefordshire PCT, Isle of Wight, Leeds Partnerships Mental Health, Lewisham PCT, Manchester PCT, Medway, Royal Surrey, Somerset PCT, West Sussex PCT, Yorkshire Ambulance.
• All of the above are hospital trusts unless stated otherwise.
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