Hospitals boss blasts medics 'ignoring the rules' as almost one in three local Covid cases are caught on the wards
The boss at Preston and Chorley hospitals has admitted there are "unacceptably high rates" of patients catching Covid-19 on the wards.
Karen Partington wrote to staff to tell them "we don't have the luxury of a softly, softly approach" following reports of medics going from "patient to patient without changing their apron or changing their gloves".
In an internal memo seen by the Post, she said: "Did you know that 30 per cent of patients who contract Covid-19 in hospital die?
"Imagine that this was someone you loved.
"Imagine that you believed that staff had not done enough to protect them.
"It doesn't bear thinking about, does it?"
While the problem is hardly exclusive to Preston and Chorley, with hospital hotspots up and down the country highlighted in a report two months ago by safety investigators, around 29.5 per cent of their Covid cases were caught on the wards from August 1 to November 29, NHS England stats showed, making the trust one of the worst in the country.
Ms Partington, the trust's chief executive, said a special board meeting was held last week to discuss the problem - and said bosses talked about "how difficult it is to get the right balance".
She said: "On the one hand we have people who have experience of working in other hospitals with high infection rates; have seen colleagues die as a result of not wearing the right PPE [personal protective equipment, such as face masks and aprons]; or have vulnerable relatives that they are trying to protect.
"They favour a very hard line and wonder why we don't do more to take action against those who do not comply with the rules.
"This week, I've had a number of porters get in touch to let me know that they are really pleased that they now feel they have permission to raise their concerns when they see people ignoring the rules.
"They have described being on wards where clinical staff have gone from patient to patient without changing their apron, or changing they gloves. I thank them for their vigilance and their approach to keeping our patients safe."
She continued: "On the other hand, we have colleagues who are doing their absolute best day-in-day-out who find it discouraging to be constantly told that they need to do more, especially when they feel there is more we could do corporately to help.
"Colleagues, we don’t have the luxury of a softly, softly approach. We all have a duty of care to our patients and whilst we have such unacceptably high nosocomial [hospital-acquired infection] rates we must take urgent action."
Medics were urged to contact bosses if they "know of any barriers that make it harder" to follow hygiene rules, but were told: "Please don't hide behind these - every single person in our hospitals has a duty to take personal responsibility for keeping our patients safe and we need every single person to do their best."
"No-one gets it right all of the time but if we all get it right most of the time we will make a difference together," Ms Partington added.
In October, a report by the Healthcare Safety Investigation Branch (HSIB) made a series of observations to help the health service reduce the spread of coronavirus in healthcare settings.
It found that central nurses' stations and areas where computers and medical notes are shared were a particular risk.
The investigation was initiated after a Sage report in May found 20 per cent of hospital patients were reporting symptoms of Covid-19 seven days following admission – suggesting that their infection may have been acquired in hospital.
In response to the report, NHS England and NHS Improvement confirmed they would publish nosocomial transmission rates from trusts, the HSIB said, though it remains relatively inaccessible and tough to understand.
Analysis of the data revealed that dozens of patients a day could have been catching Covid-19 in hospitals since mid-October.
Kathryn Whitehill, principal national investigator at HSIB, said: “The spread of coronavirus in hospitals presents a risk to patient safety.
“It also puts enormous strain on the workforce and the fear of contracting Covid-19 in hospital can deter patients from attending hospital who may need urgent treatment for other conditions.”
Earlier this week, there were 170 Covid-positive patients in hospital in Preston and Chorley, including seven in intensive care and seven in respiratory high care.
"Our total number of deaths is 492 and we have had 1,457 patients who have been discharged back home," one worker said.
A King's College London study published in July estimated that 12.5 per cent of Covid-positive hospital patients caught it during their stay, though it said that was a conservative estimate.
Dr Ben Carter, who was involved in the research, said we can "never truly know the true burden" of nosocomial transmission, and added: "It's impossible to have no transmission.
"When you’ve got something that’s very contagious and very rife within the population, it’s just hard to know," he told fact checking organisation Full Fact.
"There are so many factors against us.
"People don’t know they have got it, they can spread it for a long time, and at this stage [when the study was conducted in April] they weren’t being routinely tested.
"It’s just a really hard thing to determine.”
Dr Jim Gardner, medical director at Blackpool Victoria Hospital, said earlier this year, when discussing the issue with sister title The Gazette, that hospitals remain the safest place to be for those who need emergency care.
Following a rise in deaths of people who stayed at home with deadly conditions because they wanted to avoid going into hospital, he said: "Unequivocally, the most dangerous thing is to stay at home if something bad is happening to you pathologically, and through the course of the last 12 weeks, we have seen some really sad cases where patients have presented late in their illness and had a bad outcome as a consequence.
“We have seen examples through our heart clinics and our stroke units in particular”, though Dr Gardner said it was not immediately possible to say just how many have died.
In a statement, Ms Partington said: "All our staff are asked to rigorously follow regularly updated guidance on infection prevention and we take very seriously any reports of staff failing to do so.
“Community infection rates across Lancashire have been some of the highest in the country for sustained periods this year, and as the Office for National Statistics has made clear, high community infection rates go hand in hand with high rates of infection in NHS staff and patients which is why it’s so important the public follow government guidelines around social distancing and hygiene to reduce case numbers.”
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