Hospital hygiene - A matter of management

It emerged today that the Healthcare Commission has found Bromley Hospitals NHS Trust guilty of serious breaches of the hygiene code.

Following a series of (all too rare) 'unannounced' visits to the Trusts Hospitals, inspectors reported 'thick layers of dust on curtain rails around patients' beds’, revealing that a routine thorough cleaning practice was not in place.

Worse still, evidence of 'poor decontamination procedures' were reported, with 'soiled commodes, marked clean and ready for use', and 'a thick layer of dust ... on a blood culture bottle trolley outside an isolation ward’. Patients themselves expressed concern about the hospital's cleanliness, directing the inspectors to bloodstains on a bed rail and blood splashes on a wall behind a bed.

Examples of such poor practice are still distressingly common, but the case of Bromley Hospitals NHS Trust is revealing. Ian Wilson, the trusts Chief Executive, has only been in his post since mid-December 2007, and perhaps cannot be blamed for the Healthcare Commissions recent findings. His appointment brings to an end though, nearly 9 months of ‘interim’, externally sourced, Chief Executives, something which might well be responsible for the obvious lack of good management at the trust.

Moreover, Mr Wilson’s predecsssor, Mr Anthony Sumara, continued to work as NHS London's Turnaround Director while interim Chief Executive of NHS Bromley. One can assume that his hands on management time in Bromley was limited at best; and as he was selected specifically to cut costs, it is very conceivable that budget areas such as 'cleaning' saw a tightning in recent months.

One cannot criticise the NHS for trying to increase its economic efficiency. However one can criticize the way the NHS appears to be going about trying to achieve it. Creating a group of 'management executives' to parachute into ill-performing (in a financial sense) NHS Trusts, only to then be whisked away again after only a matter of months, will not improve the quality of care offered to patients. Real accountability and stability among NHS Trusts senior management just might. Of course perhaps the best way to improve healthcare in the UK is to learn some lessons from other European countries, and take it out of the government's hands altogether.      

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