A NURSING chief has admitted hospitals are likely to fail a key standard for cutting the numbers of superbugs this year which could mean large fines.

Targets for reducing clostridium difficile at hospitals like Worcestershire Royal Hospital in Worcester have got more stringent each year which means that although infection levels are falling, the trust is likely to fail its target for 2012/13.

As previously reported in your Worcester News the clinical commissioning groups which hold the purse strings for NHS care have the power to impose fines of up to £445,000 for each case of c.diff above the target for 2012/13.

Worcestershire Acute Hospitals NHS Trust has had 34 cases of c.diff so far this year, 14 over the trajectory.

Chief nursing officer Helen Blanchard said: “The trajectory for the end of the year is to slightly exceed our target of 52 cases. In terms of actual numbers I think we will be similar to last year. We’re focused on reducing it but I think we will be similar.

“A significant proportion of antibiotics are prescribed in primary care which changes the flora of the gut which can lead to c.diff developing. We’re very focused on cleanliness. Hand hygiene is of absolute importance and the isolation of patients with diarrhoea.”

Worcestershire Acute Hospitals NHS Trust has hit the Government targets on c.diff for the last four years but these standards have got progressively tougher each year to drive down rates of infection.

In 2008/09 the target was 310 (actual cases 189), in 2009/10 it was 198 (actual cases 125), in 2010/11 it was 110 (actual cases 92) and in 2011/12 it was 81 (actual cases 65).

Only cases diagnosed after 48 hours of a patient’s admission are classed as ‘hospital acquired’ as people who have symptoms before may have already had the infection.

C.diff does not cause any problems in healthy people but some antibiotics can interfere with the balance of good bacteria in the gut.

When this happens c.diff bacteria can multiply and produce toxins which cause illness such as diarrhoea and fever with older and more vulnerable patients particularly at risk.

More accurate dual testing was introduced last December in line with national policy which makes it increasingly likely that cases of the superbug will be identified.

Tests have been performed in externals labs which show there are different strains in the patients presenting which would suggest the bug is not being spread within the hospitals.