Saturday, June 28, 2008

Maidstone Hospital Hasn't Learned Its Lesson

My partner John has just been to Maidstone Hospital to visit his mother. It was Maidstone Hospital, you may remember, where the chief executive was fired over its dreadful record on outbreaks of MRSA.

It seems Maidstone Hosptial still has a lot to learn about cleanliness, especially at weekends. John had to try eight different hand gel dispensers before he found one with any gel in it. People often maintain that it's not a good idea to be in hospital at weekends. I can now see why.


Unsworth said...

I've had the misfortune of visiting the same hospital, too. The trouble is simply bad management. But that is largely because the old hierarchical system of nursing has been destroyed in favour of 'outsourcing'. The resultant loss of authority of line managers (as they are now called) has led to almost total abandonment of individual responsibility.

Anonymous said...

I doubt it is any better mid-week.

Anonymous said...

I was born there. The place has never recovered.

Anonymous said...

I would suggest it is about poor ward management.

We have a lot of problems with the two DG hospitals in our local trust, but there is one surgical ward which seems to be outstandingly good in all its nursing practices:

the ward is quiet and clean, drugs are properly administered, care is given promptly, bed linen is changed regularly etc, and everyone agrees it is because the ward manager keeps everything and everyone on a tight rein.

It ain't rocket science.

David said...

"I would suggest it is about poor ward management."

Quite right. My mate's wife is the staff nurse in charge of A and E. She has revolutionised the place within a month and people no longer comment about the dirt, the long waits and the anxiety they felt. The ward is now gleaming, staff are polite and well motivated and HAPPY. Get some good leaders and ward sisters in and give them full authority. At the saem time get rid of the self serving buffoons calling themselves NHS managers as they do not manage....

Curly said...

It's easier to find them at the newsagents!

Vicky Ford said...

Well done John for trying to use the alcohol gel dispensers. I visited this hospital earlier this year. Sitting in the waiting area for the Oncology (cancer) centre I was shocked by how few visitors actually tried to use them. Despite the huge signs asking people to do so and this being a part of the hospital where the patients really can not afford to pick up infections.

We should not just blame the staff or management as it must be up to the public to use the dispensers and report them when they empty. Did John report the empty dispensers to the hospital staff? Maintaining hospital cleanliness is all of our responsiblity.

Anonymous said...

Why on earth Hospitals do not have disinfectant shoe dips and hand cleansers whose use is mandatory at all entrances puzzles me. Why is it so difficult to fit cleansing stations that are so common in the food industry.

How much disease is carried inside a hospital on peoples feet? One minute they are outside treading on bird droppings, street garbage or worse. The next minute those shoes are depositing whatever they collected outside all through the hospital.You even see visitors put their feet onto patients beds.

Tapestry said...

The NHS - another reason why you should leave Britain - while you can.

Anonymous said...

Vicky Ford, you are so wrong :)

The person responsible is whoever is in charge of that ward.
To say we are all responsible, means no one takes responsibility.

Unsworth said...

@ Vicky Ford

"Maintaining hospital cleanliness is all of our responsiblity."

Absolutely no. These people are well paid to do a proper job. If I have to do their job for them then I want the right to sack them or at least castigate them for failure. I'm not in the business of 'helping'. It really should not be the responsibility of visitors or patients to 'report' the deficiencies of a badly managed hospital. Just who was John supposed to 'report' to? No doubt somewhere stuck to the walls with Elastoplast there are hand written ungrammatical notices giving a 'hotline' telephone number for an outsourced supplier who will 'log the job in' - but only during office hours, at all other times there'll be an inane and lengthy recorded message system.

There are or should be systems of daily inspection and control in place. If they are malfunctioning then those who are employed to manage them should be directly held to account. The fact that eight dispensers were/are empty is a clear indication of systemic collapse. Who is responsible for checking the hospital's systems?

Anonymous said...

Don't mention this to the Government. They will just tell you how many millions of taxpayers money they have 'invested' in training.

That's the infuriating thing. It doesn't need money. It just needs someone in charge to insist on 'action this day.'

Unlike the former administrator who, as I recall, was paid a king's ransom for doing just the opposite.

Graham Sleight said...

Richard Smith, former editor of the BMJ, has just had a similar experience with Maidstone Hospital.

Anonymous said...

Yes, I think the cleaning side of the NHS works on a 9 till 5, Monday to Friday basis.

Two years ago during a 16 day stay at The Queen Elizabeth Hospital, Welwyn Garden City, the stroke patient in the bed next to me regularly spilt the contents of his bed pan on the floor.

On one occasion where I called the nurse several times to draw the large puddle of urine to her attention, she eventually (after about 2 hours) dealt with it by throwing a sheet off a bed onto the remaining puddle to wick it up. When later removing the sheet I asked if the floor would be mopped as I was walking bare footed - I had Stevens Johnson syndrome, and could not put socks or shoes on - the reply was...
"The cleaners have gone home and all the cleaning materials are locked away in a cupboard used by the contract cleaners. We don't have access to the cupboard"

Anonymous said...

I was a patient at Maidstone recently. I found and used the dispensers with no trouble at all. I was however amused to see so many hospital staff walk in to work without going near the things....

Bernie H

Astro-Turf Lawnmower said...

Trumpeter Lanfried, you beat me to it!

Gordon's reaction to such a complaint would be to spew out five minutes' worth of tractor production statistics on £x million spent on deep cleans etc, even though the evidence of people's own experience is that hospitals are still dirty places, even for those who make such strenuous efforts to follow hygiene procedures.

Just where has all the taxpayers' money gone? Obviously not in to buying hand gel.

Anonymous said...

Just to say, in the interests of accuracy, it was C-Difficile, not MRSA.

Anonymous said...

My work sometimes takes me into fish processing plants. Before getting inside, I have to sign a form saying I have no infectious conditions,put on shoe covers, a disposable overall, head covering, walk through a disinfectant trough and wash my hands.

All legally required for a visit to dead fish.

Compare this with visiting time at any hospital ward.There should be far stricter control of visitors, and then maybe an NHS hospital stay would not be, as it is now, statistically more dangerous than mountaineering or bungee jumping.

Alan Douglas said...

Iain, not relevant to your post, but I am having nightmares, or something very akin. No, not after Dr Who last night, and the suspense it left me in, but as I click around your blog (and Guido as well), I keep getting flashes of an evil face that looks like it will gloop right out of the screen and try to gobble me up.

No idea what to call it, but the phrase "Brown Substance" keeps coming into my head.

Alan Douglas

Unsworth said...

@ Astro-turf lawnmower

"Just where has all the taxpayers' money gone? Obviously not in to buying hand gel."

Not quite right. It has gone into purchasing vast amounts of hand gel and many other items which are entirely useless in the field of patient care. But it has certainly not gone into ensuring that some operative does his/her job correctly.

Anonymous said...

You think that's bad - try being in a mental health in-patient unit -

Anonymous said...

There is no incentive to try harder -- it usually is the old and very sick who get killed by MRSA. There are huge savings to be made (pensions, future treatments for people who will never work again, etc) for the treasury in keeping the current mess-for-all the way it is and ensuring that the 'useless eaters' are highly likely to die 'accidentally'.

So many old people get neglected by the NHS, whether it's failing keeping them and their wounds clean, feeding them food or withholding treatment that would improve their quality of life.

There is method to this madness of mass murder by omission and incompetence.

I'm not sure about the actual figures, but if we (very conservatively) say it costs the state £20k per year per 'broken' oldie in the NHS/care system and that each pensioner gets about 10 years of retirement after falling ill if treated properly, that's a whopping saving of 300k per unfortunate patient who dies to 'poor ward management'.

Curmy said...

I hope he's going to write a letter to the hospital and complain Iain , even better write to your local newspaper.

There's too many people who want to appear on talent shows and be "famous" and not enough who want a vocational career.

Yak40 said...

Just another example of declining standards everywhere, another is Amy Winehouse's so called performance at the concert, she's a role model for our youth ?

"Dirty hospitals" is blamed upon the cleaning contractors by many, especially the Grauniad crowd. This is nonsense. If you outsource a task it is the local Trust that works up the contract and in that contract should be performance measures, also the local Trust should have someone administering the contract and making sure all is done properly, aided by hospital line staff/supervisors. So once again it's just incompetence and a sloppy attitude at fault.

Just mirrors the incompetence of this government really !

Anonymous said...

During a long stay in hospital some years ago it was three months before I was allowed home leave at weekends.

There were nurses around, one might even spot the occasional doctor, but as for cleaning staff, comparisons with hen's teeth and rocking horse shit come to mind.

Contracting out janitorial services has not worked so I imagine things are worse now.

But as unsworth says, its a failure of management, or rather the adoption of McKinsey style non management. Gathering and documenting information is the skill of the clerk not the manager. Managers make decisions.

it was being an old fashioned decision maker in a world being taken over by McKinsey consultants that led to my health breakdown.

Life's a bitch.

DiscoveredJoys said...

Lots of well meaning legislation about job security has made it extremely onerous to sort out staff that fail to meet an acceptable level of performance on the job. It is particualrly difficult for concerted disciplinary action to be taken against people working varied shifts, or agency staff.

Nevertheless, it can be done, and is done in some wards and hospitals. It should be seen as a key aspect of a managers job. Sort out one or two that deserve it quickly, and the rest of the staff will be happier working in an environment with clear expectations. They will also be glad that slackers will be penalised.

Anonymous said...

"... the chief executive was fired over its dreadful record on outbreaks of MRSA."

Maidstone Hospital's record on MRSA is very good.

You are getting confused with C-difficile.

Anonymous said...

Privatisation of hospital cleaning led to filthy hospitals, halved the number of cleaners, halved their pay to minimum wage and nurses lost contral

so maybe some patients died but the cleaning companies made huge profits

Anonymous said...

@tam "Privatisation of hospital cleaning led to filthy hospitals, halved the number of cleaners, halved their pay to minimum wage and nurses lost contral

so maybe some patients died but the cleaning companies made huge profits"

if you look at the facts (National Audit Office figures as only one example) there is no difference between contractors and in-house hospital cleaners. What all dirty hospitals have in common, irrespective of in-house or contract cleaning, is bad management.

Anonymous said...

of the top ten dirty hospitals in England all are private contracts as are 85% of all cleaning contracts in England

the number of cleaners have been halved fact

they are no longer accountable to the nurses fact

Why do BUPA hospitals employe their own cleaners and not contract them out ???

dont let politics get in the way of clean hospitals