Time is of the essence
April 1st 2008

The current political and media spotlight on hospital hygiene has intensified the focus on key issues affecting how hospitals are cleaned.Head of the CSSA,Andrew Large, says contractor members are collaborating to solve the problems and ensuring government sees – and acts upon – their findings

The cleaning of our hospitals, and the effect that this has on the health of patients, visitors and nursing staff is never far from the top of the agenda. Recently, it has been headline news, as the Government has launched its attentiongrabbing £57 million 'deep clean' of hospitals.

The spotlight on hospital cleaning has brought back into sharp focus a number of key issues that affect how our hospitals are cleaned today.

For CSSA members, there are three key issues that need to be addressed, and quickly if real improvements are to be made.

More focus needs to be placed on the day to day cleaning of hospital wards, and on the most important areas to be cleaned and how they can be cleaned effectively.

Once this has been determined, resources within the NHS need to flow so that the required cleaning can be properly undertaken.

The NHS, as the overall client, needs to provide more leadership and direction to individual Trusts to ensure that they make the right choices over hospital cleaning. The autonomy of individual Trusts must not be a barrier to progress; and also must not inhibit the NHS centrally, together with Ministers from taking the lead and pushing Trusts to change what they do.

CSSA approach The CSSA, as the key trade association in the contract cleaning sector, has taken a leading role in rising to the challenges posed by hospital cleaning.

We have brought the key outsourced cleaning contractors in our membership together in an active forum that enables them to exchange information and best practice. This forum is chaired by Simon Cox, the Managing Director of ISS Mediclean.

We are working more closely with a number of academic microbiologists to develop the best available evidence on what constitutes effective cleaning so that the industry can be sure that its activities are contributing positively to the fight against hospital acquired infections.

Finally, and most importantly the CSSA also has a leading role in taking the results of this work to Government and ensuring that they provide the necessary resources and commitment to implement evidence-based changes to cleaning regimes.

Cleaning Summit conclusions In response to the controversy stirred up by the deep cleans, the NHS in England recently held a Cleanliness Summit, chaired by the Chief Executive David Nicholson and attended by the Minister, Anne Keen MP. I attended on behalf of the CSSA, as did some cleaning contractors and the representatives of other stakeholders in hospital cleaning.

From my perspective, the summit was, in the modern sense, a curate's egg; good in parts. It was clearly an important initiative to take, and the cleaning industry should welcome the attention that it is getting.Moreover, I fully support both the establishment of a permanent 'Cleanliness Forum' and the gathering of existing good practice as quick wins to improve the flow of information within the NHS.

However, I also have my concerns. It seems to me that the timescales involved in the process are too long.With people dying in hospital every day of hospital acquired infections the issue of hospital cleaning requires a degree of urgency that seems currently absent. Coupled to this concern is the lack of leadership from the higher echelons of the NHS and Department of Health to drive action at the Trust level. Without more overt leadership, I fear that Trusts will be under no real pressure to change the way they manage cleaning, and that even where best practice is identified, it will not spread.

Conclusion We are at the start of a process of reform. I hope very much that it will be a short process, although some of the early signs are that it may take some time. Cleaning contractors are an integral part of the process, which is only right since they provide the cleaning to one third of all NHS Trusts. The issue of hospital cleaning is being taken seriously by all parties, and that is a good start. I just hope that the Government will provide the leadership necessary to ensure that the efforts for reform are not dissipated. After all, time is of the essence if we are to reduce the cost of hospital acquired infections to us all.

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