The Chief Medical Officer, Sir Liam Donaldson, published his Annual Report for 2006, On the State of Public Health, in which he reviews key health problems and developments.
He calls for action in five key areas:
improving levels of hand hygiene in hospitals (a key factor in infections such as MRSA) by giving patients the power to establish whether healthcare professionals have cleaned their hands and giving patients a personal supply of alcohol-based handrub tackling the present crisis in organ shortages for transplantation by introduction of an opt-out system for donors, as is done successfully in some other countries reducing the risk of radiation overdoses during cancer treatment by extending the use of monitoring devices to all radiotherapy machines in the country conducting more research to establish the reasons why 500 babies die each year despite starting the process of birth apparently healthy (‘intrapartum-related deaths’) taking steps to increase the number of women in the most senior positions in medicine.
The Chief Medical Officer is the UK Government’s principal medical adviser. His Annual Reports have championed the need for action on key public health issues such as smoke-free enclosed public places. The Chief Medical Officer also highlights the work in each of the nine public health regions.
The report in more detail: hand hygiene
Sir Liam calls for action on the unacceptably low levels of hand hygiene in hospitals. Poor hand hygiene is strongly linked to healthcare infection and incidence of superbugs like MRSA and Clostridium difficile. Despite improvements, such as the more widespread use of alcohol-based handrubs, levels of compliance by healthcare staff with hand cleaning protocols seldom rise above 60%, and are often lower. Experience in some other countries – notably Switzerland – shows that high standards of hand hygiene cuts infection rates and saves lives. Studies show that patients are reluctant to challenge doctors and nurses even when they know that they have not cleaned their hands.
To tackle this, the Chief Medical Officer proposes that:
patients should be empowered to work with healthcare professionals and ask them if they would like to clean their hands before treating them patients will be provided with alcohol-based handrubs to offer staff
Sir Liam Donaldson said:
“Good hand hygiene should be a natural reflex for healthcare professionals, yet it no longer has the status it once had. Every time a patient is touched, several thousand bacteria can be passed between the clinician and a patient. Yet patients do not feel able to ask their doctor or nurse if they have washed their hands before touching them. I believe that by empowering patients to work with healthcare professionals on this issue we can improve hand cleaning rates amongst healthcare staff and reduce the number of infections.”
The report in more detail: shortage of organs for transplantation The report also addresses the grave shortage of organs for transplantation – on average one patient a day is dying on the transplant waiting list.
The current organ donor system is based on an ‘opt-in’ approach whereby people enrol on the NHS Organ Donor Register to give permission for their organs to be used in the event of their death. Recent legislative changes to strengthen this wish – overriding that of their relatives – has done little to increase the number of organs for donation. The Chief Medical Officer therefore proposes an ‘opt-out’ system be introduced, similar to that in some other European countries which has helped improve their supply of organs. An opt-out system would mean people would register to say they specifically do not want to be donors rather than they do. Safeguards would be built in to any new system of donation.