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09-30-2007, 01:51 PM
Next steps in the drive to maintain cleanliness in hospitals and tackle healthcare associated infections were confirmed by the Department of Health.

A new hospital regulator with powers to impose fines and close down entire wards in hospitals that do not meet hygiene requirements will be introduced and hospitals across England will undergo an aggressive programme of intensive deep cleaning. This will result in a more hygienic, brighter, cleaner environment for hospital users and make it easier to maintain a clean hospital in the future.

Trusts already undertake deep cleaning programmes on a ward-by-ward basis but this will be the first time hospitals have been asked to deep clean their entire site restoring surfaces and fabrics as close as possible to their original condition.

Alan Johnson said:

"Hospital Acquired Infections are a global problem. We have made good progress bringing down infection rates, but we have to adopt new techniques if we are to go further.

"This deep-clean programme will give hospitals a one-off blitz so walls, patient equipment and ventilation ducts are disinfected and scrubbed clean, a ward at a time.

"The NHS is heading for a financial surplus this year and it is a prudent use of some of this money to provide an even better environment for patients."

Detailing the powers of the new regulator, he continued;

"Hospital infections like MRSA undermine confidence in the NHS. We will equip the new healthcare regulator with tough powers, backed by fines, to inspect, investigate and intervene where hospitals are failing to meet hygiene standards.

The new regulator will have power to impose fines and additional powers to inspect and issue warnings, as well as halting new admissions or even cancelling a provider's registration entirely.

Matrons and ward sisters will also be given further powers to report any concerns they have on hygiene direct to the new regulator and will receive whistleblower protection.

The new regulator will have a much stronger focus on safety and quality across all health and adult social care services, in both the NHS and independent sector. It will replace three existing bodies (Healthcare Commission, Commission for Social Care Inspection and the Mental Health Act commission), building on their existing experience and expertise and simplifying cross-boundary working. This will also help to reduce administrative burdens on patients and frontline services.

The announcement comes in the wake of a series of measures to tackle healthcare associated infections including;

- 50 million extra funding to Strategic Health Authority Directors of Nursing and doubling the size of improvement teams;

- New guidance on clothing which will mean that hospitals will adopt a new "bare below the elbows" dress code;

- Matrons and clinical directors will report quarterly directly to trust boards on infection control and cleanliness;

- New clinical guidance to increase the use of isolation for those patients who are infected with MRSA or Clostridium difficile;

- The National Patient Safety Agency will extend its successful cleanyourhands campaign to care settings outside hospitals; and,

- A new legal requirement to be placed on all chief executives to report all MRSA bacteraemias and C. difficile infections to the Health Protection Agency, backed by fines for non-compliance - failure to report will be an offence.

The proposals to create the new regulator will be introduced in the Health & Social Care Bill in the next Parliamentary session and Trusts will be expected to begin their deep cleaning programmes as soon as possible.

However, depending on the size of the hospital, a serious deep clean can be a lengthy process and we will give trusts flexibility to properly plan the timing and pace of the deep clean programme to ensure minimum disruption to patients.

1. Deep cleaning will often involve the deployment of more mechanical and specialist equipment, for example: steam cleaners, floor scrubbers/polishers, carpet and upholstery shampooing/cleaning equipment. The success of the first programme of deep cleaning will be fully evaluated before a decision is made about whether to repeat.

2. The deep cleaning could cost as much as 50m. Strategic Health Authorities will be expected to manage the funding of this programme from within their own regional financial plans. Each of the ten SHAs has the resources to do this in this year.

3. The Prime Minister announced in July this year (in "The Governance of Britain - The Government's Draft Legislative Programme") that the Government are preparing to bring forward a Bill early in the coming Parliamentary session to create a new integrated regulator for health and adult social care. The document can be found at http://www.cabinetoffice.gov.uk/reports/governance/index.asp (http://www.cabinetoffice.gov.uk/reports/governance/index.asp)

4. The Government will set the high-level requirements that the regulatory body will use to assure the safety and quality of care. The detail of these requirements will be set out in regulations and subject to a further consultation later in the year.

5. The establishment of the new body will mean that, for the first time NHS and independent sector healthcare providers will be subject to the same regulatory framework, giving patients will have consistent information available to them when making their choice of service provider.

6. Although the Code of Practice for the prevention and control of healthcare associated infections requires NHS bodies to report HCAI surveillance data - responsibility for this was not clearly specified. The forthcoming legislation will clarify the position, with the possibility of fines levied on the organisation for non-compliance.

http://www.dh.gov.uk (http://www.dh.gov.uk/)