HSE predicts it will need €20m a year to combat healthcare-acquired infections

The Health Service Executive (HSE) believes that up to €20 million will be needed each year to combat healthcare-acquired infections and antimicrobial resistance.

It says much of the additional money will need to go towards providing more consultant microbiologists, infection-control nurses, pharmacists and surveillance staff.

A new HSE internal briefing paper said analysis carried out last year identified "a significant resource deficit" in the health service compared with recommendations in the official Strategy for the Control of Anti-microbial Resistance in Ireland (Sari), which was launched in 2001. The briefing paper maintained that the HSE has proposed a new action plan to run from this year to the end of 2008.

"The approach seeks to both substantially rectify over the period the deficits in the infrastructure for combating healthcare acquired infection [ HCAI] and to create a sustained programme of targeted action on evidence-based effective interventions across the whole system," the paper said.

"To achieve this, it has been estimated that an additional €5 million a year in each year from 2006 to 2008 is required, which would ultimately give just under €20 million per year spent in combating HCAI/ antimicrobial resistance."

At present, about €5 million is spent annually in Ireland on combating MRSA and healthcare- acquired infections.

The briefing paper said the level of investment proposed in this area needed to be set against previous estimates that HCAI afflicts 5-10 per cent of hospital admissions at any one time, adds to length of stay and probably costs the system 2-5 per cent of its budget.

Under the plan, the HSE will spend €3.5 million this year on 52 additional posts, with the priority being on the appointment of infection-control nurses and pharmacists.

The paper said that in 2007 and 2008 the main emphasis would shift to the provision of consultant microbiologist posts.

"The intention would be to have an additional 12 consultant microbiologist posts and around 60 extra control of infection nurses/pharmacists," it said.

While there has been some progress on tackling anti-microbial resistance since the launch of the Sari strategy in 2001, "much remains to be done", it said.

"In the first instance, we need to prevent antimicrobial-resistant rates increasing and subsequently we need to work harder to try to lower the prevalence of resistance among such pathogens as Staphylococcus aureus, enterococci and other important pathogens.

"Finally, education needs to be a continuous theme of the Sari implementation programme. This must include ongoing education of all healthcare professionals and the public to reiterate the importance of this issue and the valuable resource that antibiotics represent when used appropriately, so that antimicrobial- resistance can be curbed."

It suggested that an infection- control information campaign for healthcare workers, which could be used in community residential settings and in general practice, could cost up to €1 million.

It also said there was a need for a nationwide public education campaign giving basic information on healthcare-associated infection, hand hygiene and prudent use of antibiotics. It estimated that this could cost about €2 million over a two-year period.

The paper said that in the medium to long term, "capital funding will be required to increase the number of single rooms and isolation facilities [ in hospitals] in keeping with best international practice in hospital design".

The paper said the HSE was conscious that some patients felt they had been given little or inadequate information about their condition. It said the HSE would work with hospitals and medical staff to ensure that adequate information was provided to patients.