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24 September 2014
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Week In Week Out: Special Investigation


One of Wales's leading hospitals has promised a major overhaul of hygiene and security after an undercover investigation by Ö÷²¥´óÐã Wales's Week In Week Out programme revealed shocking failures.

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Tonight's programme on Ö÷²¥´óÐã One Wales also exposes how the deadly hospital bug clostridium difficile (c.diff) has spread much further and infected far more patients than has ever been publicly reported in Wales.

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Secret filming at the Royal Gwent Hospital in Newport shows how measures to control the spread of potentially deadly infections such as c.diff were ignored.

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Ö÷²¥´óÐã Wales's undercover journalist was hired as a cleaner through recruitment agency Smart Solutions. Noone checked her references or whether she had a criminal record. After just 10 minutes' training on how to use a mop and a bucket she was working alongside agency and hospital cleaners on the wards, where she filmed serious breaches of hygiene policy which increase the risk of spreading infections such as c.diff.

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C.diff forms tiny spores which can be passed on via clothing or contact and, unlike the MRSA bug, cannot be eliminated by simply using the special gels found on most wards.

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Instead it has to be wiped away, while cloths and disposable gloves and aprons have been used for cleaning have to be carefully disposed of to reduce the risk of cross-contamination.

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The bug can cause serious infection of the bowel and is resistant to most antibiotics. In fact, taking antibiotics can cause the infection to take hold, as it remains when other bacteria – both good and bad – have been killed off by medication.

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The infection is a growing problem for hospitals across Wales. Families of patients who had the bug at the Royal Gwent had already complained about hygiene standards and improvements had been promised.

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Sybil Monahan, aged 77, from Blackwood, died at the hospital last November. Her family complained to the Gwent Healthcare NHS Trust about poor cleaning practices during her stay. They received an apology and were assured things would get better.

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Sybil's daughter-in-law, Suzanne Monahan, says: "We never, ever expected her to die in hospital. If we'd known beforehand, in hindsight, it's a wonderful thing, but if we'd known that this was going to be the outcome, we would never have let her go in there, ever."

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But almost six months later, the undercover investigation showed there were still major problems.

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While working at the hospital the journalist witnessed a catalogue of failures to follow infection control procedures including:
  • Cleaners failing to use disposable gloves and aprons which could have stemmed the transfer of c.diff spores or other infections
  • Nurses failing to pass on information to cleaners about how a room should be treated
  • Using the same mop and the same cloths to clean barrier and non-barrier rooms
  • Food being served next to where bags full of infected linen were kept
  • Areas timetabled for a "deep scrub" left undone because cleaners couldn't get round all their duties in time.

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The Trust's Medical Director, Dr Grant Robinson, says that in light of Week In Week Out's evidence it is reviewing its hygiene and recruitment policies and procedures. He has promised an inquiry and major improvements.

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Smart Solutions says it has complied with the requirements of the Trust and will continue working with it to improve all aspects of the recruitment process.

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The Royal Gwent is not the only hospital with hygiene problems.

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The widow of a patient who died at The University Hospital of Wales in Cardiff has been promised an inquiry after failures in the care of her husband Ray Rees, who suffered c.diff on the wards last year. Ann Rees, from Ystrad Mynach, was not told that he had it.

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Ray, who was 65, was not isolated from other patients and staff didn't explain the implications of the infection. After being treated he was discharged from hospital but quickly had to be re-admitted when the severe symptoms of c.diff returned. He underwent surgery to remove his bowel but never recovered.

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Ann believes that if she had been told he had the infection, she could have got help sooner. She says: "He was left here to die in front of my eyes for four days and it's unforgivable. I can't forgive them for that."

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The hospital disputes knowing Ray had the bug when he left hospital but Ian Lane, Medical Director of the Cardiff and Vale NHS Trust, admits the case highlights failings in communication and infection control.

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Tonight's Special Investigation also reveals that the deadly c.diff bug has spread much further and infected far more patients than has ever been publicly reported in Wales.

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Rates appear lower than in England, because unlike their counterparts, the Wales Public Health Service does not include victims under the age of 65. In England, there is a more comprehensive picture with all patients aged two and over included in published statistics.

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Using the Freedom of Information Act, the programme discovered that in some parts of Wales hospitals had treated far more patients than had been publicly reported.

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The Chief Medical officer for Wales, Dr Tony Jewell, says the method for collecting and publishing figures is going to be reviewed.

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Week In Week Out: Special Investigation is on Ö÷²¥´óÐã One Wales at 7.30pm tonight (Monday 2 June).

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Ö÷²¥´óÐã Wales Publicity Team

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Category: Factual & Arts; Wales
Date: 02.06.2008
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