The best available estimates suggest that annually there are at least 300,000 cases of hospital acquired infection, causing 5,000 deaths and costing the NHS £1 billion. This report follows on from a report by the Comptroller and Auditor General ( HC 876 2003-04, ISBN 0102929157) and examines the progress made by the Department of Health and NHS trusts in reducing the risks. It looks at three main areas: the extent and impact of hospital acquired infection; improving knowledge of and compliance with good infection control practice; improving infection control systems and management processes. The conclusion is that progress has been patchy, with a lack of urgency on several key issues such as ward cleanliness and hand hygiene. Progress has also been hampered by a lack of data, a national mandatory surveillance programme and evidence of the effectiveness of different intervention strategies

The Department of Health introduced a target to reduce MRSA across all NHS trusts by 50 per cent by 2008 and C. difficile by 30 per cent by 2010-11. MRSA had been reduced by 57 per cent by the end of March 2008 and C. difficile by 41 per cent. While a quarter of trusts have reduced MRSA by more than 80 per cent, in 12 per cent of trusts there has been an increase in MRSA infections. Twenty-nine per cent of trusts have reduced C. difficile by more than 50 per cent, but in 19 per cent of hospital trusts the numbers of C. difficile infections have increased. Since the introduction of the targets, the Department has spent some £120 million tackling healthcare associated infections. There have also been unquantifiable administrative costs and local expenditure on the drive to reduce infection rates. These initiatives have led to savings on treatment of between £141 million and £263 million, as well as reducing discomfort, disability and, for some, death that might have been caused by these avoidable infections. There has also been a perceptible change in trust leadership on tackling infections. The impact has not, however, been the same in all trusts or for other infections. Following the Department's intervention to improve recording on death certificates where MRSA or C. difficile was the underlying cause or a contributory factor, in 2007 around 9,000 people were reported as having died in such circumstances. There is still no national information on deaths from other healthcare associated infections such as urinary tract infections and pneumonia and blood stream infections due to other causes may be increasing.

This book provides all the necessary information in a readablestyle that can be understood by anyone with even the most basicknowledge of mathematics Health Economics is ideal for allhealth professionals who are required to make policy decisions– including hospital managers, clinical directors andpartners in family practices. It is suited to health policy makersat national level as well as those in local trusts. The clear andconcise way in which the book is written also makes it a perfectintroductory text for students of health economics. Health Economics provides you with the tools to: Read and critique economic evaluations Understand the economic forces at work in specificenvironments Make optimum choices in terms of benefits and outcomes

No official statistics are kept for the number of hospital patients, in particular older people, who are subjected to neglect and abuse. That is, left malnourished and dehydrated, in pain, allowed to develop agonising and fatal pressure sores, not taken to the toilet, left to lie in their own bodily waste, cared for in a filthy environment and at risk of infection, ignored, allowed to fall over repeatedly, not spoken to, left naked or dressed in other patients' clothes - and discharged from hospital prematurely. This book bears witness to all these practices and more. Setting out a wealth of evidence not previously brought together, Michael Mandelstam shows beyond question that neglectful care is a systemic blight, rather than mere local blemish, within our health services. He analyses the causes and factors involved, reveals the widespread denial and lack of accountability on the part of those responsible - and spells out the political, moral, professional and legal implications of this failure to care for the most vulnerable of patients with humanity and compassion. Most important, Mandelstam points to the main obstacles to a solution - and to how they can be removed and change be accomplished. This book should be read by anyone concerned with the state of our health services, including National Health Service users, government policy makers and planners, public health practitioners and academics and researchers.

Paul Elliott has drawn together a thought-provoking collection of topics that together explain the psychology of infection prevention and control. This is a book about how to change and improve practice, written by people who understand the trade of infection prevention and control. Reflection exercises are cleverly used throughout the text to provoke the reader to think of their own experiences in and their practice of healthcare. The reader is led into considering how improvements can be made to the delivery of infection prevention and control, and at the same time to understand why the way we think ultimately determines the likelihood of their success. Each reflection exercise is accompanied by clear and concise explanations, helping the reader to analyse and critique him/ herself and the way we do things now.

The Oxford Handbook of Clinical Skills for Children's and Young People's Nursing provides a concise, current, and evidence-based practical guide to all clinical skills relating to the care of children and young people.

This volume examines many of the crucial issues of resistance in a clinical context, with an emphasis on MRSA; surely the greatest challenge to our antibiotic and infection control policies that modern health care systems have ever seen. Other chapters explore the psychology of prescribing, modern management techniques as an adjunct to antibiotic policies, and the less obvious downsides of antibiotic use.

The Oxford Handbook of Perioperative Practice offers readers practical, easily accessible, concise and up-to-date evidence-based information on the essential elements of perioperative practice. It provides a thorough introduction to the principles and practice of anaesthetics, intraoperative care and recovery nursing, focussing on the patients' journey before, during and after surgery. Containing many helpful illustrations and diagrams to guide the reader, along with references to national and international guidelines, the Oxford Handbook of Perioperative Practice assists practitioners in meeting the individual needs of surgical patients while ensuring safe and efficient care delivery. It enables readers to easily locate information about essential skills, patients' medical conditions, and perioperative and surgical patient management. It covers all steps of the perioperative process, and also contains an extensive section on pharmacology, as well as a section on perioperative emergencies. The book is clearly laid out, and written in an easily readable note-based style. Blank pages are included for the reader, so that notes, observations, and local protocols can be included, thereby individualising the Handbook. Written by teaching staff and clinicians from the fields of nursing, operating department practice and pharmacy, the Oxford Handbook of Perioperative Practice offers an inter-disciplinary and inter-professional approach to perioperative practice for those studying the subject and those practising within the perioperative environment.

Road congestion is estimated to cost industry and commerce £3 billion a year, with around 7% of the motorway and trunk road network suffering heavy congestion at peak times. Although the Government has set a target to stabilise congestion at 2000 levels by 2010, it has acknowledged that this will not be achieved. This report, which follows-on from a report by the NAO (HC 15 2004-05, ISBN 010293150X), looks at how the Highways Agency is tackling the problem. It concludes that the Agency has been too risk averse in testing and using measures adopted abroad and that they have failed to give motorists the information they need to make choices before and during their journeys.

Traditionally dentists are independent contractors who choose where to locate their premises and how much NHS dentistry to provide. Over the past 10 years there has been an increase in the number of patients experiencing difficulties in accessing NHS dentistry and during this time there has also been pressure to reform the dental remuneration system. In 2003 major changes were announced in which Primary Care Trusts were to be given responsibility for commissioning NHS dental services and a deadline of October 2005 was set for implementing new contracts. This report looks at how the risks of the service are being managed including the mismatch between supply and demand, the ability of Primary Care Trusts to commission services and variations in oral health.