Outsourcing cleaning services increases MRSA incidence: Evidence from 126 english acute trusts

Area of Science:

• Healthcare Management
• Infection Prevention and Control
• Health Economics

Background:

• Extensive outsourcing of hospital cleaning services in England's NHS aims to reduce costs.
• Concerns exist regarding outsourcing's impact on hygiene standards and hospital-acquired infections like MRSA.
• Health services in Scotland, Wales, and Northern Ireland have opted against outsourcing.

Purpose of the Study:

• To evaluate the association between contracted-out cleaning services in English acute hospital Trusts and the risks of hospital-borne MRSA infection.
• To assess the economic costs associated with outsourcing hospital cleaning services.

Main Methods:

• Linking data on MRSA incidence (per 100,000 hospital bed-days) with cleanliness surveys.
• Analysis covered 126 English acute hospital Trusts between 2010 and 2014.
• Patient and staff perceptions of cleanliness and handwashing facilities were surveyed.

Main Results:

• Outsourcing cleaning services correlated with increased MRSA incidence.
• Fewer cleaning staff per hospital bed and worse patient/staff cleanliness perceptions were observed in outsourced Trusts.
• Outsourcing was associated with reduced economic costs, excluding infection treatment expenses.

Conclusions:

• Contracting out hospital cleaning services in England is linked to higher MRSA infection rates and diminished cleanliness perceptions.
• Despite potential cost savings, outsourcing may compromise patient safety and hygiene standards.
• Further economic analysis should incorporate the costs of treating hospital-acquired infections.