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90 hospital patients died from C-diff superbug in at Kent hospitals

By David Gazet

Ten years ago this month, a damning report into outbreaks of the Clostridium Difficile (C-diff) superbug at Maidstone and Tunbridge Wells NHS Trust (MTW) shocked the nation.

The Healthcare Commission revealed at least 90 patients died from the Clostridium difficile (C-diff) superbug at Maidstone and Tunbridge Wells (MTW) Trust hospitals between April 2004 and September 2006.

Now the Care Quality Commission, it also found as many as 1,170 patients were infected with the bug in the same period.

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Beds pushed close together and poor cleaning was blamed for allowing infection rates to spread
Beds pushed close together and poor cleaning was blamed for allowing infection rates to spread

The scandal became one of Britain’s most notorious flashpoints of hospital infections.

A catalogue of failings led to the spread of the diarrhoea-inducing condition, including poor cleaning and infection control, understaffing and the prescription of strong antibiotics.

One of the most shocking testimonies came when an overworked nurse told a patient suffering from the chronic bug to: “Go to the toilet in your bed.”

The report, formed of hundreds of interviews with staff, managers, relatives and patients, also found many other people were left in soiled bedding by staff who did not always have time to wash their hands or equipment.

It revealed relatives’ distress at the conditions they were seeing on the wards.

Health inspectors also found issues raised by staff had been ignored and bosses had been too slow to react to the outbreak.

It sparked a political crisis, thousands in government cash were pledged for a deep clean, amid calls for the trust’s entire board to resign.

Protesters get their message across
Protesters get their message across

Kent Police and Health and Safety Executive investigated the findings of the report to see if a case for criminal wrongdoing could be made – but in 2008 concluded there wasn’t.

Rose Gibb, the trust’s chief executive, stepped down a week before the report was published, followed by a slew of other board members, including the trust’s chairman.

In 2010 Rose Gibb won £190,284 in damages from the trust, and claimed she was demonised by the press and made a scapegoat in the Health Commission’s report.

MTW was formed as a result of a merger in 2000. In 2007 it comprised three hospitals; Maidstone, the Kent and Sussex Hospital at Tunbridge Wells and Pembury.

The Kent and Sussex Hospital and the old Pembury hospital closed in 2011 and a modern building – the Tunbridge Wells Hospital – now stands on the Pembury site.

The road to recovery

In 2008, a year after the Healthcare Commission’s findings were published, bosses pledged to families the scandal would never happen again.

With vastly reduced infection rates today, the woman responsible for keeping the trust’s promise on C-diff has much on which she can reflect.

The UVO automated disinfection system
The UVO automated disinfection system

Dr Sara Mumford took on the mantle of director of infection prevention and control in November 2007 when morale was at its lowest ebb.

She said: “I think the trust was slightly stunned. Having the media outside was very demoralising for staff because actually in between the outbreak occurring and the report being written they had already done a massive amount of work to improve the situation.

Having it all come back again was a tough time for everybody.

“I was involved before I came here in what was then the Health Protection Agency, so we were involved in the outbreak investigation.”

She said the main causes were antibiotic prescribing and a recruitment freeze which was later lifted but left difficulties with staffing, and a higher workload meant less checking of cleaning.

Over the past decade MTW has seen infection rates fall by at least 96%. New training has been rolled out to staff, safeguards put in place and cutting edge technologies adopted.

These include hydrogen peroxide fogging, and using UV light to decontaminate wards and operating theatres.

Alan Johnson, who was then Health Secretary, washing his hands as he visits Maidstone Hospital in the immediate aftermath of the C-diff crisis
Alan Johnson, who was then Health Secretary, washing his hands as he visits Maidstone Hospital in the immediate aftermath of the C-diff crisis

MTW also screens most patient transfers for the superbug MRSA, with only one reported case in the past year.

Last year Dr Mumford shared MTW’s story with delegates from 30 countries at an international conference in Edinburgh.

She added: “We have a number of processes in place, such as surveillance so we are very good at spotting infections and identifying them early.

"We have a really good relationship between the microbiology laboratory and the infection control team which is important so they alert each other to issues and we get those early diagnoses.

"With these we could not have another C-diff outbreak in that way.

"There are new threats, I don’t want to say never, because there is so much unknown and there are new micro-organisms which have caused outbreaks at other trusts and have come out of the blue.”

She added: “We regret what happened and we have done everything possible to prevent anything like that happening again.

Jackie Stewart
Jackie Stewart

"It’s very sad and we feel for those families who have lost loved ones but we have had some relatives come back in to see what we have done and they have been very encouraged by the changes we have made and they are very encouraged we are doing the right thing.

Trust under pressure

Glenn Douglas was chief executive at Ashford and St Peters Hospitals in Surrey when the report was published and he got a call asking him to move to Maidstone and Tunbridge Wells NHS Trust (MTW).

Mr Douglas, who left MTW last month, said: “It was quite scary actually.

“My first week I was constantly in the media and people like me are not trained for anything like that.

Chief executive Glenn Douglas. Picture: Matthew Reading
Chief executive Glenn Douglas. Picture: Matthew Reading

“The biggest problem when I joined was a revolving door in senior management and a constant churn of people.

"I think it is quite important to have consistency.”

He found a perception the C-diff infection was an inevitable consequence of some procedures when it was entirely avoidable.

“There have been a number of issues but I was brought in to make a difference to infection control and 10 years on we have seen a quantum shift in attitudes and we have influenced the national agenda.”

He praised staff and is proud of the care offered at the trust.

No forgiveness

A woman who lost her mother to C-diff at the height of the outbreak says while her family can never forgive the trust for what happened, she has confidence in the boss currently leading the fight against infection.

Jackie Stewart rushed her mother Mary Hirst into Maidstone Hospital after a fall, but the 83-year-old contracted the superbug twice and died in May 2006.

The 65-year-old is among several families who sued the trust over care given to relatives.

“It is 11 years since mum died and 10 years since the report come out,” said Mrs Stewart from Bearsted.

“Even after all this time we still feel so bad, it should never have happened.

“My mum went into that hospital fighting fit. She took no medications, nothing and she had never been in hospital in her life. She even had four children at home.

Mary Hirst
Mary Hirst

“Eleven years on and we still look at her photograph and I wonder - ‘how did that happen’?”

"I will always blame Maidstone Hospital for my mother’s death to the day I die...it took them two years to send us a letter of apology" - Jackie Stewart

Mrs Stewart, like several other relatives, had tried to raise concerns over hygiene standards in the wards, but felt previous managers fobbed them off and didn’t take concerns seriously.

She added: “I will always blame Maidstone Hospital for my mother’s death to the day I die.

"It took them two years to send us a letter of apology.

"If they had sent us that letter even a few months after her death we wouldn’t have taken it further.”

The Plantation Lane resident is one of several family members invited to the hospital by Dr Sara Mumford, to see what has changed.

Mrs Stewart added: “When they brought her in she did a fantastic job.”

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