LONDON (Reuters) - An NHS trust could face criminal action after a damning report said appalling hygiene, a shortage of nurses and poor management contributed to outbreaks of a hospital superbug that killed about 90 patients.
The police and Health and Safety Executive are examining the findings of the Healthcare Commission report to see whether action should be taken against the Maidstone and Tunbridge Wells NHS Trust over the Clostridium difficile outbreaks.
The commission found that on several occasions nurses had told patients to “go in their beds” rather than helping those with diarrhoea to get to a toilet or bathroom. Some patients were left for hours in wet or soiled sheets.
Patients with the bug were moved between wards and managers of the Trust in Kent had failed to set up special isolation areas for them. The watchdog blamed a focus on meeting government targets for emergency admissions.
“It took four months to establish an isolation ward exclusively for patients with C. difficile. In our view this was partly because of the pressure on beds and the trust’s desire to meet targets,” the report said last week.
The bacterium, commonly transmitted while patients are in the hospital, most often affects those with weak immune systems and the elderly. Figures show cases of the potentially lethal bug in hospitals are on the rise.
The Commission, which described the events at the Maidstone, Kent and Sussex, and Pembury Hospitals as a tragedy, said there had been 1,176 cases of C. difficile during outbreaks between 2004 and 2006.
It estimated about 90 patients had died as a result.
“The clinical management of C. difficile infection in the majority of the patients fell short of an acceptable standard in at least one aspect of basic care,” the report said.
“Some patients, who might have been expected to make a full recovery from the condition for which they were admitted, were prescribed broad-spectrum antibiotics during their stay in hospital, contracted C. difficile and some died.”
The Health and Safety Executive said it would be looking to see whether there had been any failures that required further investigation.
“We and Kent Police are considering the report and whether we need to take any further action,” a spokeswoman said.
Meanwhile the Commission has called on the Trust to review its leadership and to take urgent measures to ensure control of infections was treated as a priority.
“What happened to the patients at this trust was a tragedy,” said Anna Walker, the Commission’s chief executive. “This report fully exposes the reasons for that tragedy, so that the same mistakes are never made again.”
Dr Malcolm Stewart, the Trust’s Medical Director, acknowledged there had been a failure of basic systems and that the organisation had not been prepared for such an outbreak.
“I would have to say the Trust like all other trusts at that time in the NHS was not prepared for an outbreak of Clostridium difficile of this size and complexity,” he told BBC radio.
Last month the government announced a series of measures to tackle the rise of hospital bugs, some of which were criticised by a leading medical journal as populist moves that would have little impact.
Health Secretary Alan Johnson denied that government targets had contributed to the Trust’s failures, which he described as a “scandal” for which there was no excuse.
“To suggest that ... this reflects what is happening in the NHS across the country is absolutely wrong,” he told BBC radio.
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