NHS overcrowding is spreading superbugs, say surgeons

Guardian October 17 2008

Persistent overcrowding on NHS hospital wards is causing an uncontrollable spread of superbugs and other forms of infection, the Royal College of Surgeons warned last night.

Its leaders called on the government to publish the bed occupancy rate for every ward and hospital unit in England, allowing patients to choose to be treated where conditions are safe.

Surgeons should become whistleblowers to alert the public to the risk of infection whenever overcrowding occurred, the college said.

The college intervened after a report yesterday from the Healthcare Commission that 60% of hospitals in England are failing to deal with superbug infections effectively. The commission called for rigid adherence to the NHS hygiene code. But the college said good hygiene was not enough and infection would persist if the NHS did not tackle overcrowding and understaffing.

According to Department of Health guidelines, wards where patients stay overnight should not have an occupancy rate of more than 82% - allowing time for beds to be decontaminated between patients.

The college said the NHS measured the bed occupancy rate across entire trusts and tried to keep the average below 82%. Managers were not held to account for overcrowding in individual wards. The college said: "There are more factors at play than just handwashing in the transmission of these infections and the public needs better access to this information to make informed choices about where to go for an operation."

Overcrowding was often compounded by understaffing. "The staff-to-patient ratio must be high enough to ensure patients with infection can be appropriately cared for in isolation beds."

All NHS units should screen patients for hospital-acquired infections. Although antibiotic-resistant superbugs were particularly pernicious, it was unacceptable for any patient to be infected by the NHS.

Surgeons should follow all hygiene guidelines laid down by their trust, even if the scientific evidence for a particular guideline was slender. For example doctors should obey a government edict requiring NHS staff in contact with patients to be bare below the elbow.

John Black, the college's president, said: "We think every patient booked in for an operation should have the right to infection information for the individual ward they are going into."

He asked surgeons to report directly to the college if wards were overcrowded or understaffed. "If the government does not feel able to make this information public, we will."