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Lack of resources aggravates risks of hospital infections

Infection control sign manc160915 16x9

Doctors leaders have warned that a lack of expertise and resources in infection control is putting patients in Scottish hospitals at risk.

The BMA in Scotland has called for action to ensure hospital buildings and other healthcare settings are built and maintained in a way that minimises risk of infection.

Responding to a Scottish Parliament health and sport committee inquiry into health hazards in the healthcare environment, the union says clinicians with expertise in infection control should be part of hospital design.

However, it warns the consultant workforce is stretched, and that few infection-control teams have the capacity to contribute fully to major projects, even where they asked to do so.

The BMA points out that infections acquired directly from healthcare environments are rare but that consequences can be severe.

‘With well-engineered and maintained buildings, with sufficient staff to deliver healthcare, the risks should be low,’ the BMA says in its evidence.

‘In a system under financial pressure, with staffing levels often stretched thinly and a significant maintenance backlog, the risks can begin to rise and infection, while still relatively rare, can be more common.’

 

Knock-on effect

The BMA warns that tightening resources across the health system as a whole can have a negative effect on infection control.

For example, staff shortages mean that nurses are working with increased numbers of patients, raising the risk of cross-infection, and hospitals.

A high maintenance backlog and cost-cutting – for example, making compromises to squeeze in as many beds as possible, or using temporary buildings beyond their design life – also contributed to increased risk.

The BMA says that some health boards should be praised for creating specialist nurse or scientist posts in the infection-control team to develop the knowledge and expertise needed to deal with the problems of buildings.

However, it warns of a lack of budget for training staff to ensure they are able to do this, saying that while there are courses available, the fees vastly outweigh study-leave budgets.

 

Pigeonholed

The committee’s inquiry was announced amid concerns about infection control at the flagship new Queen Elizabeth University Hospital in Glasgow, where patients have been infected with a fungus linked to pigeon faeces.

A 10-year-old boy and 73-year-old woman who had contracted cryptococcus later died.

A Healthcare Environment Scotland inspection revealed areas of concern including a maintenance backlog and cleaning deficiencies.

Speaking when the inspection report was published, Lewis Morrison (pictured below), chair of the BMA in Scotland, said that it was ‘unacceptable’ that some parts of the site were in such poor repair that they could not be cleaned.

‘A further theme that comes through is shortages of staff – including infection control doctors, who play a crucial role with the assessment and mitigation of infection risks presented by the built environment.’ Dr Morrison added.

‘Without the right staff in place, it is hard to see how real improvements can be made. Equally, there would also appear to be issues with senior management acting on concerns of the clinical staff who are in place – for example in estates meetings. The board must act urgently, as they have set out in their action plan is response to the report, to deal with these critical issues and make improvements across the board.’

NHS Greater Glasgow and Clyde, the health board responsible for the hospital, said work was under way to address the issues raised in the report, and that infection control and prevention was a top priority.

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