Written - Clostridium difficile

Several Assembly Members have recently expressed concern about Clostridium difficile (C.difficile) in NHS Wales. This has been prompted by the Week in Week Out programme and the news that three patients’ deaths were directly attributed to C.difficile during an outbreak at Prince Charles Hospital, Merthyr during April.

I can assure you that I take this issue very seriously and that the Welsh Assembly Government is committed to tackling C.difficile as a core element of our wider strategy against all Healthcare Associated Infections. We have a range of initiatives in place or currently in development which will assist us in that fight. A summary of these is attached in the annex to this statement. Please note that we have always collected laboratory data on the under 65 year old group but this is quite different to our over 65 year old mandatory surveillance system. We will be extending this surveillance system and its reporting to the over 2 year olds in future.

Members will recall that in October last year, I established a Task and Finish Group to consider re-empowering ward sisters within the NHS in Wales and to develop a plan to ensure that they have the authority, knowledge and skills to improve the hospital environment and standards of care. The report which contains 35 recommendations on aspects such as cleaning of the ward environment and accountability and responsibility for cleaning, will be formally launched on 26 June. In addition, I will be responding formally to the National Assembly Audit Committee’s report on HCAIs on 19 June.

In respect of Prince Charles Hospital, senior officials in the Chief Medical Officer’s Department are satisfied that the Trust responded quickly to manage the outbreak. I now need to be confident that the Trust has put in place measures to reduce the risk of infection even further and that when infections occur, that measures are put in place to reduce the spread. To this end, I have asked Health Inspectorate Wales (HIW) to carry out an immediate independent review of the concerns raised about the number of cases of C.difficile at Prince Charles Hospital, Merthyr.

The public is naturally concerned about healthcare associated infections but I would reassure them that we have the policies and guidance in place based on the best evidence. I have asked HIW, over the next few months, to carry out a programme of focussed reviews on how well each Trust in Wales is dealing with C.difficile. It will also continue with spot unannounced checks and investigate further any instances where causes for concern are identified. HIW will be supported in this work by staff from the National Public Health Service and the Department of Public Health and Health Professions.