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Hepatitis C

Tim Loughton: To ask the Secretary of State for Health what his latest estimate is of the number of people in the UK infected with hepatitis C; what assessment he has made of the origin of infection for most hepatitis C sufferers; and how many people are receiving treatment for hepatitis C. [198431]

Miss Melanie Johnson: Information about the estimated prevalence of hepatitis C infection in England and likely routes of transmission is contained in the "Hepatitis C Action Plan for England", a copy of which is available in the Library. It is also available on the Department's website at http://www.dh.gov.uk/assetRoot/04/08/47/13/04084713.pdf.

On the issue of hepatitis C treatment, I refer the hon. Member to the reply I gave on 26 October 2004, Official Report, column 1196W, to the hon. Member for Mid-Worcestershire (Mr. Luff).

Information about hepatitis C in Scotland and Wales is a matter for the respective devolved administrations. While the institutions in Northern Ireland are dissolved, responsibility for hepatitis C rests with Ministers in the Northern Ireland Office.

Hospital-acquired Infections

Mr. Lansley: To ask the Secretary of State for Health which (a) procedures and (b) products that claim effectiveness in their ability to prevent or control methicillin resistant staphylococcus aureus have been introduced by the NHS as a result of the Department of Health's rapid review processes. [193454]

Miss Melanie Johnson: The rapid review panel has reviewed seven products and findings on each of these products will be available shortly for people to take decision locally on their use.

Mr. Lansley: To ask the Secretary of State for Health (1) if he will list the research projects he (a) has commissioned and (b) plans to commission on reducing hospital acquired infections which will be funded from the Winning Ways programme; how much funding will be allocated to each project; what completion date he will set for each project; and what projects have been commissioned with funding from other sources; [195039]
 
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(2) if he will list (a) the research initiatives he has commissioned into hospital acquired infections in the last year and (b) the funding source for each initiative. [195040]

Miss Melanie Johnson: The Department last year commissioned a £2.5 million strategic programme of research aimed at improving scientific understanding of antimicrobial resistance from the Department's policy research programme budget. £590,000 of that total sum will be spent on projects that will provide useful information relating to best practice in preventing methicillin-resistant Staphylococcus aureus.

Funding for research associated with "Winning Ways" will be drawn from the same source. The one "Winning Ways" project commissioned to date is the "National observational study of the effectiveness of the Clean Your Hands campaign and a cluster randomised controlled trial of the effectiveness and cost-effectiveness of feedback in intensive care units and acute general medical wards". A call for proposals for research into the cost-effectiveness of interventions aimed at controlling the spread of infection will be published early next year.

Mr. Lansley: To ask the Secretary of State for Health what sources of funding are available for research into hospital acquired infections. [195041]

Miss Melanie Johnson: The main agency through which the Government supports medical and clinical research is the Medical Research Council (MRC). The MRC is an independent body funded by the Department of Trade and Industry via the Office of Science and Technology.

The MRC always welcomes high quality applications for support into any aspect of human health and these are judged in open competition with other demands on funding. Awards are made according to their scientific quality and importance to human health.

The Department allocates funds to National Health Service organisations to meet the NHS support costs associated with clinical research undertaken in the NHS by the MRC and other research bodies, and for investment in local research and development priorities and needs. The Department also directly funds a research programme that provides a knowledge base for health and social care policy including policy on hospital acquired infections.

Mr. Lansley: To ask the Secretary of State for Health what evidence he used as the basis for introducing the Cleanyourhands campaign. [195146]

Miss Melanie Johnson: Development of the campaign was informed by a number of academic papers. One key study 1 in Geneva, Switzerland found that the introduction of alcohol hand rub and an accompanying promotional campaign increased hand hygiene compliance and led to a decreasing infection rate. The pilot study of the Cleanyourhands campaign revealed a significant increase in staff cleaning of hands between each patient contact.


 
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Mrs. Curtis-Thomas: To ask the Secretary of State for Health what guidance he has issued on improving patient care through reducing hospital-acquired infections. [195486]

Dr. Murrison: To ask the Secretary of State for Health (1) what guidance the Department has issued to the NHS concerning the (a) content and (b) availability of information to patients on the risks of hospital-acquired infections; [194895]

(2) what information NHS hospitals make available to patients prior to hospital admission on protecting against the risk of (a) hospital-acquired infections and (b) MRSA; [194896]

(3) what information is provided by his Department to (a) primary care trusts, (b) general practitioners and (c) hospital staff to inform patients about the risk of hospital-acquired infections. [195281]

Miss Melanie Johnson: Guidance on advising patients is given in, "Prevention of healthcare associated infection in primary and community care—Understanding NICE guidance—information for patients, their carers and the public."

As patients with MRSA and other conditions may need locally produced supporting information, the Department has produced a generic toolkit for creating patient information. This has been placed in the Library and is also available on the internet at http://www.nhsidentity.nhs.uk/patientinformationtoolkit/.

Information on materials provided locally by hospitals is not collected centrally.

Tim Loughton: To ask the Secretary of State for Health how many cases of methicillin sensitive staphylococcus aureus have been reported by each hospital trust since 2001. [197942]

Miss Melanie Johnson [holding answer 15 November 2004]: Data for methicillin susceptible Staphylococcus aureus (MSSA) bloodstream infections analysed by individual acute national health service are not readily available.

Tim Loughton: To ask the Secretary of State for Health which hospitals screen patients for (a) MRSA and (b) MSSA on admission to (i) orthopaedic wards, (ii) critical care units and (iii) children's wards. [197943]

Miss Melanie Johnson: [holding answer 15 November 2004]: Information on screening is not collected centrally.

Tim Loughton: To ask the Secretary of State for Health what drugs are approved for use against methicillin sensitive staphylococcus aureus in hospitals; and if he will make a statement on their effectiveness. [197944]

Miss Melanie Johnson: [holding answer 15 November 2004]: The prescribing information, which is laid out in the summary of product characteristics, for 150 licensed medicinal products states among the indications that the drug might be used to treat infections due to methicillin-susceptible "Staphylococcus aureus" (MSSA). These licensed medicinal products concern 21 different antibacterial agents.
 
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However, because the prescribing information for more recently approved antibacterial agents lists only clinical infection types as indications, for example, skin and soft tissue infections, there are in fact many others that are active against MSSA and which have been shown in clinical trials or can be predicted from in-vitro studies to be suitable for treatment. The choice of agent from among all the possible drugs depends on factors such as the patient, the infection, the hospital formulary, professional guidance documents, physician experience and, when available, the results of microbiological laboratory test results.

The drug that is most commonly recommended, as in the British National Formulary, for treating methicillin-susceptible "Staphylococcus aureus" is flucloxacillin, which is a type of penicillin. Patients who cannot be given flucloxacillin for any reason are most usually treated with a macrolide, such as erythromycin. Information on the effectiveness of these drugs comes from clinical trials and mainly from long years of experience with their use.

Tim Loughton: To ask the Secretary of State for Health what different monitoring systems are used by hospitals to ensure sterilisation of beds between patients. [197945]

Miss Melanie Johnson [holding answer 15 November 2004]: The use of monitoring systems to ensure decontamination of mattresses between patients is for local determination and no information is held centrally.
 
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Every national health service trust has been required to appoint a director of infection prevention and control and we would expect that person to ensure that there are satisfactory arrangements in place.

In addition, specific advice and guidance on the cleaning/disinfection of mattresses was included in the NHS "Healthcare Cleaning Manual", which was issued in April 2004.

Tim Loughton: To ask the Secretary of State for Health what central guidance is used by hospitals for reporting hospital-acquired infections which manifest themselves after patients have left hospital. [197946]

Miss Melanie Johnson [holding answer 15 November 2004]: There is no central guidance on the reporting of hospital-acquired infection which occurs after discharge.

Mr. Burstow: To ask the Secretary of State for Health how many nosocomial cases of small round-structured viruses there were in (a) England and (b) each strategic health authority in each month in (i) 2003 and (ii) 2004 to date. [194265]

Miss Melanie Johnson: The Health Protection Agency (HPA) has a voluntary reporting system for outbreaks of gastroenteritis, including those caused by norovirus, formerly known as small round structured virus, norwalk or norwalk-like virus.

The HPA received reports of 89 outbreaks of norovirus affecting 2,384 people (patients and staff) in hospitals in England from 1 January 2003 to 2 November 2004. Data is not available broken down by month.

The table shows data on cases by region. Data at strategic health authority level are not available.
General outbreaks of norovirus infection in hospitals by region—England and Wales, 2003–04 1

2003
2004 (to date)
RegionNumber of outbreaksNumber affectedNumber of outbreaksNumber affected
East Midlands221215
East of England121845103
London42762108
North East3619216
North West2523615319
South East2444143
South West11261404
West Midlands1180
Yorkshire and Humberside1410
Total511,076381,308


(69) Data for 2004 is provisional.
Source:
Health Protection Agency





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