Comment

20.02.17

Time to act in the fight against AMR

Source: NHE Jan/Feb 17

Katherine Murphy, chief executive at the Patients Association, calls on the government and the healthcare community to work together to combat the growing economic and human costs of inadequate infection control and the crisis of antimicrobial resistance (AMR).

Established in 2015 to address key areas of healthcare policy impact on patients, the All Party Parliamentary Group for Patient Safety, run by the Patients Association, has held an inquiry into AMR and healthcare-acquired infections. The result is the publication of our report, ‘Time to Act: Inquiry into Hospital – Acquired Infections and Antimicrobial Resistance’. Taking evidence from clinicians, academics and NHS England, the APPG has produced a broad outline of the issue and made clear recommendations for taking steps to combat it.  

The threat of AMR is nothing short of cataclysmic for medical science not only in the UK, but for every country, in every continent and for every individual. The rise in the incidence of healthcare-associated infections (HCAIs) and the increasing prevalence of AMR in the UK is a clear cause for concern. The chief medical officer, Professor Dame Sally Davies, suggests that the global costs of AMR are profound, and it has been estimated that if we do not act now AMR could account for 10 million extra deaths a year and a cumulative cost of £100tn of economic output by 2050. In addition, with the progress of AMR, these infections will become harder and more expensive to treat as the arsenal of available, effective treatments becomes more limited.  

In England, more than 6% of hospital patients acquire some form of infection during the course of their hospitalisation. This economic strain on the NHS is not irreversible, but provides a potential for NHS trusts to make savings. There is a consensus that a 15% reduction in HCAI is achievable, which would avoid costs of around £150m annually.

The Patients Association has received a number calls on its national helpline in regards to HCAIs. For instance, one caller’s mother unfortunately passed away in hospital in 2016, following a seven-week stay in hospital. After being admitted for joint pain, which was subsequently treated within a two-week period, the patient was transferred to another medical ward where problems arose as the level of care declined. This resulted in the patient acquiring four infections, with care assistants demonstrating a lack of safe care through not changing her catheter which led to urinary tract infections. The patient ultimately contracted pneumonia, leading to her death in hospital.  

Based on a comprehensive overview, the report makes a number of clear policy recommendations to the government, the Department for Health, devolved health authorities and professional bodies: 

  1. The Care Quality Commission must, during its hospital site inspection, get assurance that testing and reporting algorithms are accurate, fair and represent the true burden of infections
  2. Expand existing surveillance programmes to include less well-known but increasingly prevalent infections, potentially employing supplementary electronic reporting systems. Raising awareness of the scale of infections, such as those caused by CPE (Carbapenemase-producing Enterobacteriaceae), should be considered crucial in training and educating medical staff
  3. Increase transparency surrounding infection statistics, making infection rates more accessible for members of the public. This could potentially include making statistics available in hospitals, wards and online in an easily-digestible form. Maintaining league tables of the most successful hospitals and clinics has the potential to be misleading. However, highlighting best practice and promoting shared learning from the best performers should be fostered and encouraged. Protecting informed patient choice by honouring their selection of care setting is a crucial aspect of this strategy
  4. Working with patients, their families and visitors to ensure that infection control protocols are followed at all times is an important part of reducing HCAIs. Working with the wider healthcare community and service users should be considered in all infection control and reduction strategies
  5. Standardising best practice for clinical staff and ensuring there is access to necessary equipment and consumables is integral to delivering consistently high-quality care across services and throughout the country. These best practice guidelines should be made available in an accessible way for patients and for all clinical staff. Continuing training and ongoing professional development should reflect updates to best practice
  6. Changing organisational culture to eliminate complacency and establish an expectation that no infection is inevitable, and that there is ‘zero tolerance’ for preventable HCAIs and SSI (Surgical Site Infection)
  7. Reducing the demand for antimicrobials by breaking the link between antibiotic prescription in primary care settings, applying and ensuring compliance with stringent stewardship guidelines and educating patients, staff and policymakers
  8. Implementing rapid diagnostic technologies in primary care settings and making the case for point of care testing has the potential to revolutionise treatment and save money for the healthcare system. Setting and expectation of a diagnosis as part of anti-micro bacterial prescription can play a direct role in combatting AMR and HCAI
  9. Forming an infection control covenant to share responsibility for good practice with the entire healthcare community, patients, staff and policymakers 

As previously noted, AMR is a growing issue of global concern. Decades of outmoded prescribing practices and the use of antibiotics in agriculture have driven a rise in the proportions of bacteria resistant to these life-saving drugs. As a consequence of this, the risks associated with infections in hospital and clinical settings have dramatically increased. 

The Patients Association is therefore urging the government, healthcare providers, academics and industry to acknowledge the report and its recommendations in order to work together to combat the growing economic and human costs of inadequate infection control and the crisis of AMR.

FOR MORE INFORMATION

The ‘Time to Act: Inquiry into Hospital – Acquired Infections and Antimicrobial Resistance’ report can be accessed at:

W: tinyurl.com/NHE-Patients-Association

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Ear infections should not be treated with antibiotics, doctors advised

22/09/2017Ear infections should not be treated with antibiotics, doctors advised

Common ear infections should no longer be treated using antibiotics, NICE has this week recommended. Publishing new draft guidance into the ... more >
NHS staff paid £3,800 less per year compared to 2010

22/09/2017NHS staff paid £3,800 less per year compared to 2010

Years of real-terms pay cuts have seen NHS workers earn on average £3,800 less than they would have if salary rises had kept up with inflat... more >
BMA finds ‘chronic shortage’ of doctors across key medical specialities

22/09/2017BMA finds ‘chronic shortage’ of doctors across key medical specialities

Patient safety is at risk due to a “chronic shortage” of doctors across a number of areas of medicine, the BMA has today warned. ... more >
681 149x260 NHE Subscribe button

the scalpel's daily blog

Ensuring quality in the new NHS

11/09/2017Ensuring quality in the new NHS

Dr Marion Andrews-Evans, member of the NHS Clinical Commissioners (NHSCC) Nurses Forum steering group and executive nurse & quality lead at NHS Gloucestershire CCG, sings the praises of CCG quality leads who are working in often unseen roles to help deliver safe and effective patient care. As the NHS goes through a time of change, we need to make sure that the quality of services that we provide for patients is protected. Patient ex... more >
read more blog posts from 'the scalpel' >

interviews

Improving care at the touch of a screen

08/08/2017Improving care at the touch of a screen

When it comes to dementia, having a calm and safe environment can have a substantial impact on a patient’s quality of life. NHE’s Jos... more >
A new approach to talent management

25/07/2017A new approach to talent management

Martin Hancock, national lead for talent management at NHS Leadership Academy, and Gill Rooke, the organisation’s senior operations manager... more >
Enabling greater integration through ACSs

25/07/2017Enabling greater integration through ACSs

At this year’s NHS Confed, Simon Stevens revealed the first wave of accountable care systems (ACSs). NHE speaks to Ian Dodge, the director ... more >
How NHS organisations can protect themselves against cyber crime

25/07/2017How NHS organisations can protect themselves against cyber crime

On 12 May, a global cyber-attack occurred on an unprecedented scale. It affected organisations across the globe and, though it did not specifical... more >

last word

Your personality, your leadership

Your personality, your leadership

Deirdre Wallace, clinical skills manager at UCL Medical School, discusses the importance of learning about leadership and self while at medical school. Approximately five years ago, I was ch... more > more last word articles >

editor's comment

13/06/2017Tackling the major challenges facing the NHS

As you will have gathered from the front cover, a theme that runs throughout this edition of NHE is about empowering and involving the workforce in order to deliver innovative change across the system.  Professor Jane Dacre, president of the Royal College of Physicians, highlights on page 16 the importance of sustainability and trans... read more >

health service focus

Maximising vaccine storage safety

04/09/2017Maximising vaccine storage safety

Ian Harbinson, marketing manager at Lec Medic... more >
Good procurement is the shared responsibility of all staff

31/08/2017Good procurement is the shared responsibility of all staff

As a new report this month points to the &lsq... more >