Death certificates must record death by superbugs
Pastor Dale Morgan
Death certificates must record death by superbugs*
By Gary Cleland
Last Updated: 1:10am BST 06/10/2007
Doctors must record superbugs caught by hospital patients on death
certificates to quell public fears that infection numbers are being
covered up, the chief medical officer has ruled.
Death certificates must record superbugs
Latest data show the rate of MRSA in Britain, one of the highest in
Europe, is falling
Sir Liam Donaldson has written to all doctors telling them to ensure
"healthcare associated infections" (HCAIs) such as MRSA or C.difficile
are routinely included on death certificates.
He said an infection must be recorded if it directly led to a patient's
death or was a contributory factor. It would still be "a matter of
clinical judgement" to decide if an infection present at the time of
death was a contributory factor.
Sir Liam acknowledged that the public believed official figures released
by the Government underestimated the number of deaths in which infection
had played a part.
Official records show the number of death certificates mentioning MRSA
rose from 734 to 1,629 between 2001 and 2005. Over the same period the
number mentioning C.diff increased from 1,214 to 3,807.
Sir Liam wrote: "There is still a widespread belief that the figures
underestimate the mortality associated with both MRSA and C.difficile.
"This is compounded by the idea that doctors are reluctant to put
information about HCAIs on certificates, or indeed that they are
discouraged from doing so.
"The purpose of this letter is to reinforce the message that death
certification is a significant responsibility for doctors and should
reflect a careful consideration of all the events that led up to, and
may have caused or contributed to, the person's death."
He went on: "Not only does the credibility of doctors (and the health
service) and the validity of official data depend upon accurate and
reliable death certification, but also the confidence of relatives and
the population at large in the honesty and transparency of the
profession and service."
Britain has one of the highest MRSA rates in Europe. Latest data show
the number starting to fall, however. In the first quarter of 2006 cases
fell by 7 per cent, to 1,542. But experts believe the true number is
probably higher.
Dr Peter Wilson, consultant microbiologist at University College
Hospital, said: "In the past, some doctors probably were afraid to
record MRSA because of the medical legal issues, and because in many
patients MRSA is one of a number of causes contributing to death. But
the situation has improved."
Last week the Prime Minister revealed a raft of measures designed to
combat the spread of superbugs, saying: "People need to feel confident
that their hospitals are clean."
Financial penalties could be imposed on trusts that do not meet
cleanliness standards.