NHS Blog Doctor: Filthy Patricia

I wonder if Patricia Hewitt washes her hands after she has been to the lavatory? Not if she is using one of the filthy, dirty disgusting lavatories found in at least a third of NHS hospitals.

Reported on Page 4 of today’s Times:

“More than a third of NHS hospitals and other health trusts are unable to provide their staff with hot water, soap, alcohol rubs and other basic hygiene requirements whenever they need them.”

“A total of 7212 cases of MRSA bloodstream infection were detected in English hospitals in 2004-5. Experts suggest that up t0o 300,000 infections are picked up in healthcare settings every year, causing 5000 deaths and costing the NHS as much as £1billion.”

Meanwhile, the filthy Patricia continues to throw money around as though there is no tomorrow. I am grateful to Tom Reyonold’s organisation, Paramedic UK, for pointing out to me the following:

Computer skills 'for cleaners' costs NHS £2m

“The National Health Service has spent at least £2 million on computer training for porters, cleaners and other staff after deciding to implement a European Union scheme in Britain.

The European Computer Driving Licence teaches hospital staff skills ranging from the use of spreadsheets to surfing the internet and is being offered to NHS employees irrespective of their job.

So far 50,000 staff have applied for the training, which takes between 20 and 100 hours to complete. In the past year, three million hours of tuition have been provided.

The NHS claims that £2 million has been spent on the scheme, but its real cost is believed to be far higher: the cost in man hours alone is estimated at £30 million, based on the average NHS salary of almost £10 an hour.

Training staff whose jobs appear to have little or no requirement for computer skills will heighten concern about profligate spending in the public services. The scheme's existence emerged after complaints by a senior doctor to David James, the business consultant hired by the Conservatives to expose Government waste under Labour.

The doctor told Mr James of one cleaner who had taken the course. "At long last she will be able to calculate the optimal path for her vacuum cleaner," he said.”

British Hospitals and health centres are filthy because no one, to lapse into modern jargon, takes “ownership” of the problem. Cleaning is not rocket science. It does not need computer skills. It is common sense. Dr Crippen’s health centre used to be spotlessly clean and was kept so by two ladies of mature years, who were part of the team, who came to the Christmas Party, who were liked and respected by all.

As we described here, the introduction of contract cleaners, who clean by protocol not by common sense, has destroyed all that.

This government is obsessed with process. If there is a problem, you do not attempt to tackle it, you redefine it in detail and bury it in an endless descriptive process that costs the tax payer a fortune and achieves nothing.

The filthy Patricia has produced endless documents on cleaning.

Look at: “Revised Guidance on Contracting for Cleaning” issued by the NHS in December 2004 which can be found here.

How does the filthy Patricia propose to check that cleaning has been done in areas of different "risk" in the hospital?

Very high risk
Over a period of a week all rooms within a very high risk functional area should be audited at least once.

High risk
Over a period of one month all rooms within a high risk functional area should be audited at least once.

Significant risk
Over a period of 3 months all rooms within a significant risk functional area should be audited at least once.

Low risk
Over a period of 12 months all rooms within a low risk functional area should be audited at least twice.

Look in more detail at so called “High risk functional areas”:

"High risk functional areas may include general wards, sterile supplies, public thoroughfares, and public toilets"

So general wards are going to have the same level of supervision as the public toilets. This may explain why some of Dr Crippen's patient compare their stay in hospital with being resident in a public toilet.

When ‘Towards Cleaner Hospitals and Lower rates of Infection’ was published in July 2004, the Secretary of State undertook to produce guidance for the NHS to ensure that in future contracts for cleaning were driven by quality rather than price.

This document takes the first step in meeting that undertaking.

It provides:-

A best practice guide on evaluating and awarding contracts so that quality is considered alongside price
Revised National Specifications for Cleanliness (formerly the NationalStandards of Cleanliness) which set out clearly the standards whichhospitals should provide as a minimum
The recommended minimum cleaning frequencies which need to be followed to achieve the National Specifications
A revised Healthcare Facilities Cleaning Manual which has been adapted into a web-based document and which will be updated regularly – and at least quarterly, to reflect changes in cleaning technologies and practices.

More words. More flannel. More prevarication. We do not want documents entitled “Towards cleaner hospitals.”

We want more cleaners.

It goes on and on. The hospitals are filthy. Instead of cleaning them, the filthy Patricia is asking if there is any evidence to prove that dirty hospitals increase the risk of patinet infection.

Look at this report from the University of Cardiff, commissioned by UNISON:

"This paper brings together research on two distinct but related subjects: infection control in hospitals and the contracting out of public services. It argues that despite some reluctance to acknowledge a link between hospital cleanliness and infection, such a link exists and the standards of hospital cleaning have declined."

In other words, Patricia is not even necessarily accepting that filth cause filth.

Shit smells Patricia, shit smells. And if hospitals are dirty, and doctors and nurses cannot wash their hands, patients are at risk of infection. Semmelwiss showed that two centuries ago.

Look at the simplistic American approach in this document entitled: Dr. Semmelweiss Was Right: Washing Hands Prevents Infection

It is all going wrong in the UK. We are acutally infecting the patients. But there is no "simplistic" American approach. Instead there is the usual otiose document, this time entitled "Winning Ways: Working together to reduce Healthcare Associated Infection in England."

It should be called, "Wash you bloody hands." This is back to Hospital at Night with Sue and Dave

___________________
Estimated prevalence of healthcare associated infection
Country % of hospitalised patients contracting HAI

Australia 6
Denmark 8
England 9
France 6-10
Netherlands 7
Norway 7
Spain 8
USA 5-10

Source: Various, cited in Chief Medical Officer (2003) Winning Ways: Working together to reduce Healthcare Associated Infection in England.

Department of Health.
____________________

Nothing to be proud of there. And it gets worse.

Between 1999 and 2002, the UK recorded ‘significant increases’ in the prevalence of MRSA among blood isolates and the country is in the highest prevalence group in terms of MRSA in Europe (Tiemersma et al, 2004)
____________________
HOSPITAL CONTRACT CLEANING AND INFECTION CONTROL

Proportion of Staphylococcus aureus bacteraemia isolates resistant to methicillin in various European countries

Country %
Greece 44.4
UK 41.5
Republic of Ireland 41.2
Italy 40.9
Croatia 36.7
Portugal 34.7
Bulgaria 33.9
France 33.1
Spain 24.8
Belgium 23.6
Slovenia 18.4
Poland 17.7
Germany 13.8
Slovakia 10.5
Austria 8.8
Hungary 7.1
Czech Republic 5.9
Finland 1.0
Estonia 0.9
Sweden 0.8
Netherlands 0.6
Denmark 0.6

Source: European Antimicrobial Resistance Surveillance System (EARSS), Tiemersma et al, 2004.
______________

You filthy, disgusting woman, Patricia.

Meanwhile, having made sure that all the hospital cleaners are computer literate, is she making sure that they are doing some cleaning? She has promised to audit their work.

Amongst all the process and protocol how is the monitoring of the contract cleaners going?

The filthy Patricia was asked three simple questions:

For each year since 2000, can you list the contractors and hospitals in which NHS cleaning contracts have triggered penalty clauses and the sanctions applied in each case?
For each year since 2000, can you list the contractors and hospitals in which NHS cleaning contracts have been terminated as a result of poor performance?
Which cleaning contractors at which hospitals have had payment withheld since Matrons were empowered to advise that payment be withheld when services persistently fail to achieve the standards set at local level?

And what did the filthy Patricia say?

She said: “Following a search of our paper and electronic records, we have established that this Department does not hold the information requested under points 1, 2 and 3 of the request.”

She has lost the data. She does not know how the cleaners are performing. She does not know if she is getting value for money.

You do not believe that, do you? It is true. The questions was asked here, last year. You have to see it in print to believe it.

Dr Crippen feels ashamed to be working in Britain.

And the dog turd under his desk, fully described here, remains untouched