Healthcare Commission welcomes improvements

For immediate release: Thursday 20 December 2007

HEALTHCARE WATCHDOG ENCOURAGED BY SIGNS OF IMPROVEMENT AT MAIDSTONE & TUNBRIDGE WELLS NHS TRUST

The Healthcare Commission said today (Thursday) that Maidstone and Tunbridge Wells NHS Trust is improving infection control and providing better care for patients with Clostridium difficile (C. difficile).

It said it would carry out further unannounced checks to ensure that improvements are sustained and that the trust continues to work on areas such as recruiting more nurses and learning from cases of infection.

A team of inspectors from the Commission last week conducted an announced two-day visit at Maidstone Hospital and Kent and Sussex Hospital, visiting 22 wards and interviewing 20 members of staff.

The trust has been under close scrutiny since the Commission began an investigation into infection control. The investigation report, published in October, highlighted serious concerns about the quality of care for patients with C. difficile and made wide-ranging recommendations to improve infection control.

The report estimated that 90 patients “definitely” or “probably” died at the trust as a direct result of the infection between April 2004 and September 2006.

The trust now has a new leadership team in place, including an acting chief executive, an interim chairman and director of nursing, and several new board members. It has already begun to implement an action plan to address the recommendations, which will be monitored by the strategic health authority.

The Commission will later next year report on progress in the 12 months following the investigation.

During the visit last week, the Commission found that:

• The standard of cleanliness and general environment in the wards visited has improved.
• Restrictions have been lifted on using bank and agency nurses and on filling vacancies. The trust is in the process of recruiting more nurses, however there are still shortages on some wards. The Commission will continue to closely monitor numbers of staff at the trust.
• There is a new director of infection prevention and control (DIPC), who has greater interaction with the trust’s leadership.
• The trust plans to appoint two senior infection control nurses and an additional consultant microbiologist.
• The trust responded appropriately to a small outbreak of C. difficile in November. It established an isolation ward at Maidstone Hospital and at Kent and Sussex Hospital, patients with C. difficile are cared for in single rooms.
• Most staff interviewed demonstrated that they considered infection control to be a personal responsibility, not just the responsibility of the organisation.
• Staff reported that communication with the leadership is better.

The Commission noted that there is a new document to record all aspects of care for patients with C. difficile. It said the trust must ensure that all relevant clinical staff use the document in order to improve the monitoring and management of the infection.

The Commission also said the trust should consider how it could best learn from cases of C. difficile and use the information to make improvements.

Dr Heather Wood, who led the Healthcare Commission’s investigation, said: “We cannot expect wholesale change overnight and these are still early days. But the trust prepared well for the announced visit and we saw some encouraging signs of improvement.

“It is obvious that infection control is now a very high priority at the trust and that C. difficile is beginning to be recognised as a serious diagnosis in its own right, not just a clinical complication. This can only serve to improve the care of patients.

“The key now is for the trust to sustain improvements and to continue to implement the recommendations we made in October. We’ll be keeping a close eye on how the trust is managing infections and will be making at least one unannounced visit to check on progress.”

Notes to editors

FIGURES ON C. DIFFICILE CASES:

• Latest figures published by the Health Protection Agency on 1 November 2007 show that between April and June this year, 89 patients aged over 65 were found to have C.difficile at Maidstone and Tunbridge Wells NHS Trust. This represents a 46% decrease in the number of cases compared to the same time in 2006. More recent data from the trust reports that 60 patients were found to have C. difficile in the next quarter, July to September 2007. During October 2007, 19 patients were found to have C. difficile
• A report of the Healthcare Commission’s inspection at Maidstone and Tunbridge Wells will be published on the Commission’s website early next year. 

Information on the Healthcare Commission

The Healthcare Commission is the health watchdog in England. It keeps check on health services to ensure that they are meeting standards in a range of areas. The Commission also promotes improvements in the quality of healthcare and public health in England through independent, authoritative, patient-centred assessments of those who provide services. 

Responsibility for inspection and investigation of NHS bodies and the independent sector in Wales rests with Healthcare Inspectorate Wales (HIW). The Healthcare Commission has certain statutory functions in Wales which include producing an annual report on the state of healthcare in England and Wales, national improvement reviews in England and Wales, and working with HIW to ensure that relevant cross-border issues are managed effectively.

The Healthcare Commission does not cover Scotland as it has its own body, NHS Quality Improvement Scotland. The Regulation and Quality Improvement Authority (RQIA) undertakes regular reviews of the quality of services in Northern Ireland.

For further information contact the press office on 0207 448 0868, or on 07779 990845 after hours.