31 January 2009

Speaking out is not recommended

Long before the Jobbing Doctor entered the blogosphere there were those that suggested in their comments that Dr Grumble sometimes holds back. In the words of the Jobbing Doctor himself, Grumble is very circumspect about his own views. Dr Grumble pleads guilty.

Over the years Dr Grumble has often suggested that perhaps we do not have enough beds in our hospitals. This is not something he has held back on within his own trust. He has sent an email to all and sundry arguing the case for more beds. Since then the beds have been cut. Ranting can vent ones wrath but it often achieves little.

Instead Dr Grumble is going to post some words from the Investigation into outbreaks of Clostridium difficile at Maidstone and Tunbridge Wells NHS Trust. Read these and form your own opinion. Here they are:

The infection control team was keen to isolate patients with C. difficile but the scarcity of side rooms made this difficult.

Many of the wards did not have sufficient ...... hand basins, making the control of infection difficult. The beds on several wards were much too close together, making it difficult to clean between them.....

When we visited, we observed levels of contamination that were unacceptable, such as bedpans that had been washed but were still visibly contaminated with faeces.

...it took four months to establish an isolation ward. It is our view that this was largely because of the pressure on beds and the requirement to meet financial and waiting time targets. The same pressures led to some patients moving from ward to ward. The other patients ..... were at risk of catching the infection and some of them did. This was not acceptable.

[Patients' families] told us that when patients rang the call bell because they .... needed to go to the toilet, their call often wasn't answered, or not in time. Particularly distressing, nurses had told patients to "go in the bed", presumably because this was less time consuming than helping a patient to the bathroom. Some patients were left, sometimes for hours, in wet or soiled sheets, putting them at increased risk of pressure sores (pdf).

Dr Grumble's views on this are superfluous. The problems are obvious. The action that is needed is obvious. But has that action been taken?


Anonymous said...

It would appear that Rose Gibb feels that she has been blamed unfairly for the avoidable deaths from hospital acquired infections during her tenure at Maidstone and Tunbridge Wells. If anyone is interested in knowing the actual priorities of the this NHS Trust, take a look at the minutes of the meetings of the senior management during this period.

As far as one can tell, this matter was raised by a senior member of the nursing staff, but no immediate practical suggestions for action are recorded. Frankly the matter does not seem to be regarded with the urgency that one would expect.

The meeting then moved on to the more important topic of the new PFI building project, which was clearly regarded with great enthusiasm.

As one of the most senior people attending that meeting, I think it is fair to say she must be held responsible for the content of these meetings and the attitudes they display. She cannot claim the terrible shortfall in the service at the Trust was not her responsibility, when it is clear that she had been made aware of the situation prior to the terrible results became news.

subrosa said...

I do wish I lived near Maidstone because I'd check it out.

Being a survivor of c.diff hopefully I've made a slight difference to my own local hospitals because I've shouted and shouted at my MSP and the Scottish Health Secretary.

Also I did a one woman protest outside the offices of my local Trust regarding the cleaning contracts.

It appears things have improved. Maybe it's because, when I have to attend owing to leftover health problems from c.diff, they have a secret code on my file saying 'wash your hands with this dame around', I don't really care.

Up here, from February, every member of the public who has access to a computer, will be able to check out any Scottish hospital for rates of c.diff and MRSA.

Helpful info for you too doc :-)

Dr Grumble said...

If infection with C. difficile is preventable, which to some extent it is, there are a lot of people out there who have not been doing their jobs properly because, until recently, the figures have been shooting up.

Dr Grumble said...

Actually, Subrosa, Dr G was searching unsuccessfully for the C diff rates for individual hospitals. He had heard that there were other hospitals with similarly bad C diff rates which had not hit the headlines. If that is the case perhaps it is not surprising that the figures are hard to come by.

Dr Grumble said...

Here are some relevant data:

Annual counts and rates of C. difficile (January 2004 - December 2006) ExcelSpreadsheet 80 KB

Anonymous said...

How can anything be considered "washed" when it is "visibly contaminated with faeces"?