Health Care Associated Infections and the Cleaner Hospitals Campaign

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2008 Health Care Service Group Conference
14 April 2008

Conference notes with concern that in England the majority of NHS Trusts are unlikely to meet their target, pledged by John Reid in November 2004, of halving Methicillin-Resistant Staphylococcus Aureus (MRSA) incident rates by April 2008.

Conference is also concerned about the rise in incidence of Clostridium difficile (C diff) which now poses a bigger threat to life than MRSA.

The Healthcare Commission’s findings from its investigation into outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells NHS trust is also a cause for alarm.

Although media focus has centred on the incidence of MRSA and C diff in England the issue applies across the UK as a whole.

Whilst welcoming announcements by the government for further investment for more Matrons and its ‘deep clean’ programme UNISON believes that the failure to address the issue of HCAIs is one of systemic failure and in particular a distinct lack of leadership with managers preoccupied with the target driven requirement to deliver on finance instead of focusing on cleaning and the issues of MRSA and C diff.

Bed occupancy rates in excess of 95% are common in many hospitals across the UK, well above the government target of 85%, also contributes to the spread of superbugs.

The Government steadfastly refuse to acknowledge that the halving of the numbers of cleaning staff and the privatisation of cleaning services has had a devastating impact on hospital cleanliness. A situation that has actually worsened in those Trusts which were forced to make cuts under the recent Turnaround regimes.

Unison maintains that the halving of cleaning staff over the last 20 years is directly linked to the increase in incidence of MRSA.

UNISON believes that a ‘whole’ team approach is required to find solutions and combat the issue of HCAIs yet the government continues to fail to recognise the value and significance of cleaning staff in providing ‘clean’ hospitals. Cleaning staff provide a professional service with an in-depth knowledge and skill that is currently undervalued and unrecognised by the government in providing clean hospitals.

UNISON is also of the view that to achieve ‘clean’ and ‘safe’ hospitals there must be sufficient, properly trained and equipped cleaning staff and there must be a significant increase in the number of cleaning staff throughout the NHS across the UK.

Conference recognises the value of ‘Clean Hospital Committees’ established in some NHS Hospitals as a positive step towards providing a coordinated local approach to tackling HCAIs utilising relevant knowledge, experience and expertise of staff and adopting a ‘team’ approach

Conference calls on the SGE to build on the excellent work already initiated by UNISON and the Ancillary & Maintenance Committee and continue with the Think Cleaners, More Cleaners = Cleaner Hospitals campaign at a National, Regional and branch level.

Conference instructs the Service Group Executive: develop a clear strategy based upon the findings of the UNISON commissioned research into MRSA and the reduction in cleaning staff; and lessons learned from reports and studies into MRSA and C diff; enter in to discussions with the government, devolved administrations and NHS organisations to establish and implement ‘Clean Hospital Committees’ in all NHS Hospitals. The composition of these committees should reflect a whole team approach and utilise the knowledge, experience and expertise of all relevant staff -cleaners, domestic supervisors, nurses and managers, to lead the fight against HCAIs. In setting and monitoring cleaning standards; call upon the government and devolved administrations to acknowledge the direct link between the reduction in the numbers of cleaning staff and the incidence of MRSA and to make it a requirement that all NHS organisations have safe minimum staffing levels for their cleaning services with cleaning services that are based on quality, not cost and with staff receiving proper, up to date training and equipment; call upon the government, devolved administrations and NHS organisations to uphold their obligations under the two-tier workforce agreement and the implementation of Agenda for Change for all cleaning staff across the UK; call upon the government, devolved administrations to address the issue of bed occupancy rates by developing capacity to enable the 85% target to be met.