Poor NHS Communication Leaves Elderly at Risk of Superbugs

By David Rose, Times Online 

September 21, 2009

United Kingdom

Poor communication between NHS hospitals and care homes may be putting elderly people at risk of contracting MRSA and other infections, the health and social care regulator has warned. 

The Care Quality Commission (CQC) found nearly one in five homes in England were not being told if patients discharged from hospitals were or had been infected. 

Even when they were told, the data was sometimes incomplete or illegible, the survey of more than 1,000 care homes found. 

The watchdog also highlighted poor practice by care homes - a quarter were not following guidelines covering issues such as isolating residents with infections and antibiotic management. 

Rates of MRSA (methicillin-resistant Staphylococcus aureus) and Clostridium difficile have been falling in NHS hospitals in the past year after a concerted Government campaign to improve hygiene. 

But the CQC warned that not enough is being done to prevent infections passing to and spreading within care homes as staff may be unaware if a patient has a bug. 

Hospitals are meant to include a written infection history on discharge summaries. But the survey revealed 17 per cent of care homes said they did not receive information from hospitals, while another 28 per cent complained of incomplete and ineligible data. 

Ambulance crews were also often left out of the loop despite offering a useful bridge between hospitals and care homes. Where there was communication about patients, it was verbal and not written down. 

The study said: “Care homes and hospitals are required to provide information on infections to each other. 

“However, this does not happen in a co-ordinated way, which means that people with an infection may not receive the most effective care and recover more slowly, or not at all - and they may pass their infection on to others as a result.” 

The CQC added that care homes had until next year to follow the guidelines or they may not be allowed to officially register with the regulator and barred from providing care until they improved. 

Cynthia Bower, the regulator’s chief executive, said: “Infection prevention and control is not simply an issue for hospitals - care needs to be clean and safe wherever it is provided. 

“If we are to tackle infections effectively we need to check that all providers of care are talking to each other.” 

A separate CQC report also criticised the way patient information was being used. 

The regulator said it had concerns about privacy - a third of staff said they had not been given training on confidentiality - while delays in hospitals sending GPs information after discharge were also noted. 

NHS figures show a continued fall in the number of people contracting MRSA and C. difficile. 

Data from the Health Protection Agency (HPA) showed a drop in the number of infections from April to June 2009. 

There were 509 cases of MRSA in England, a 39 per cent drop on the same quarter last year and a 27 per cent drop on the previous quarter this year. 
There were also 6,855 cases of C diff in people aged two and over between April and June 2009. 

This is a 37 per cent drop on the same quarter last year and an 18 per cent drop on the previous quarter in 2009. 

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