Dirty hospital practices revealed

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See some footage from the undercover filming

One of Wales' leading hospitals has promised a major overhaul in hygiene after an undercover BBC investigation exposed cleanliness failings.

Secret filming by a BBC Wales reporter taken on as a cleaner at the Royal Gwent Hospital in Newport showed flaws which increased the risk of infections.

Week In Week Out also found that a deadly hospital superbug was infecting more people than previously thought.

Officials are now reviewing hygiene and recruitment policies and procedures.

The programme, to be shown on BBC One Wales at 1930 BST on Monday, shows how the journalist was hired as a cleaner through the recruitment agency Smart Solutions.

No-one checked her references or whether she had a criminal record, and after 10 minutes of training with a mop and bucket, she was working on the wards alongside agency and hospital cleaners.

It was there that she filmed serious breaches of hygiene policy which increased the risk of spreading infections such as the superbug Clostridium Difficile (C.diff).

This included:

• Cleaners failing to use disposable gloves and aprons which could have stopped the C.diff bug spreading to other patients
• Nurses failing to pass on information to cleaners about how a room should be treated
• Using the same mop and the same cloths to clean ordinary wards and rooms which were specialised "barrier nursing" areas
• Food being served next to where bags full of infected linen were kept
• Areas timetabled for a "deep scrub" left undone because cleaners couldn't get round all their duties in time.

Undercover reporter: ' I still hadn't had any training'

Dealing with measures such as these are crucial in the battle against the C.diff bug, as unlike MRSA infections, it cannot be killed by just using special hand gels.

The infection needs to be wiped away and cloths and aprons used to carry out the task need to be carefully disposed of, to ensure that the tiny C.diff spores aren't passed on through clothing or touch.

The bug itself can cause severe bowel infections which are resistant to most antibiotics - in fact, antibiotics often make the infection worse.

Complaints

The infection is a growing problem for hospitals across Wales. Families of patients who had the bug at the Royal Gwent had already complained about hygiene standards, and improvements had been promised.

Sybil Monahan, who was 77 and from Blackwood, died at the hospital last November. Her family complained to the Gwent Healthcare NHS Trust about poor cleaning practices during her stay.

Sybil Monahan's family received a hospital apology after her death

They received an apology and were assured things would get better. Her daughter-in-law Suzanne Monahan told Week In Week Out that "if we'd known that this was going to be the outcome, we would never have let her go in there." But almost six months later, the undercover investigation showed there were still major problems.

Trust medical director Grant Robinson said in light of the evidence, it was reviewing its hygiene and recruitment policies and procedures, and he promised an inquiry and major improvements.

Smart Solutions said it had complied with the requirements of the trust and would continue working with it to improve all aspects of the recruitment process.

Publicly reported

The programme said the C.diff bug had spread much further and infected far more patients than had been publicly reported in Wales.

Rates appear lower than in England, because unlike their counterparts, the Wales Public Health Service does not include victims under the age of 65.

In England, there is a more comprehensive picture with all patients aged two and over included in published statistics.

Using the Freedom of Information Act, the programme discovered that in some parts of Wales, hospitals had treated far more patients than had been publicly reported.

Chief medical officer for Wales Dr Tony Jewell said the method for collecting and publishing figures would be reviewed.

He said laboratories were examining specimans from patients of all ages so it was known how many patients had postive tests for C.diff in Wales and it was about 20% of the overall picture.

On the issue of hygiene in Welsh hospitals, Dr Jewell said Health Minister Edwina Hart would be announcing new plans later in the month that would empower ward sisters to take much greater control of ward cleaning and the visitors coming into and out of hospital wards.