In an exclusive opinion piece for Nursing Times to coincide with World Antibiotic Awareness Week, health secretary Jeremy Hunt sets out progress so far in the new war on superbugs announced by the government last year.
Good infection control is a touchstone issue for the public. For proof, look back to the mid-2000s, when NHS hospitals were plagued by superbugs like MRSA and Clostridium difficile (C. diff).
Opinion polls back then showed that only just over half of the public felt the NHS was a safe place to be treated: fast forward to 2014, and that figure rose to nearly 80%.
What happened in the meantime is the NHS started to put safety, and the specific issue of infection control, at the heart of its work.
The result has been a 51% fall in MRSA and a 46% fall in C. diff over the last seven years, giving us one of the best records in Europe for reducing healthcare-acquired infections.
More recently, similar progress is being made in identifying and managing life-threatening conditions like sepsis, where the proportion being screened and treated promptly in A&E and on the wards have increased significantly over the last two years.
“Exactly a year ago this week, I spoke of the need for a new war on superbugs”
It is one of the reasons why last week, the OECD’s authoritative study of healthcare systems singled out the UK for implementing “more widely and deeply” than anywhere else our measures to monitor and improve quality in healthcare.
But is the NHS ready for the next big challenge?
Last summer, we set out ambitious plans for action on anti-microbial resistance by responding to Jim O’Neill’s landmark report and exposing AMR as a defining, existential threat to modern healthcare.
And exactly a year ago this week, I spoke of the need for a new war on superbugs, particularly targeting healthcare-associated gram negative infections and setting a target of achieving a 50% fall in these types infection by 2021 – in effect mirroring the reductions seen in MRSA and C. diff.
So what progress has been made?
First, we said we would improve reporting of gram-negative infections. While trusts continue to report E.coli blood stream infections, the vast majority of hospitals are now also tracking incidences of Klebsiella spp (94%) and Pseudomonas aeruginosa (90%): an essential first step for putting the spotlight on these infections and helping us to expose variation.
“NHS Improvement and Public Health England is providing tailored support and practical resources to help Trusts identify and implement the right improvement measures”
Second, we’re spreading good practice. NHS Improvement and Public Health England is providing tailored support and practical resources to help Trusts identify and implement the right improvement measures. There’s no one-size-fits all solution for every provider – but things like clinical case reviews and the sharing of lessons through performance improvement networking events can help.
And third, because around three-quarters of all E. coli cases originate in the community, we’re encouraging wider action across the whole health and care system. Under the new Quality Premium that was introduced from April, CCGs are now leading on efforts across their health economies to reduce all E. coli infection by 10% this year.
The result is that over half of CCGs are currently reporting lower E. coli rates than last year – a promising start in reversing the year-on-year rises seen in recent years.
But with up to 6,000 people potentially dying from gram-negative infections each year, and many more suffering unavoidable pain and discomfort, this remains a critical test for the NHS – and one that it will need to answer if it is to protect and grow its reputation as the safest healthcare system in the world.