Concern over mystery of Homerton Hospital’s soaring infection rate

GV of Homerton University Hospital, of Homerton Row.

GV of Homerton University Hospital, of Homerton Row. - Credit: Archant

Homerton Hospital has been criticised for not having dedicated orthopaedic ward

Infection rates following joint replacements at Homerton University Hospital are believed to be running as high as 10 times the national average.

The problem with orthopaedic surgical infections dates back a decade and is considered so serious that Public Health England was called in, which has not dismissed figures as “statistial fluctuations”.

Director of infection prevention and control, Dr Alleyna Claxton, presented a special report to the board of directors last month, outlining what steps the hospital in Homerton Row is taking to bring down the infections following hip and knee replacements.

It can be devastating for the patient, often requiring additional surgery and hospitalisation, prolonged antibiotic therapy, intensive rehabilitation and impaired mobility during treatment.

Dr Claxton described how they were dealing with “a very small number of infections which are happening intermittently”, spiking in 2013 with 15 per cent of the 40 knee replacement operations carried out over a three-month period resulting in infection.

No root cause has been identified, but the hospital does have plans to create a dedicated ward.

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Retired surgeon and former staff governor Andrew Eszias criticised Homerton for not having done so before, expressing concern orthopaedic patients were often placed next to others who were “unclean”, having undergone colorectal procedures or who have a stoma – a surgical opening on the abdomen for stools or urine to exit the body. This goes against British Arthroplasty Association guidance.

Mr Ezsias said: “Joint replacement is a strictly sterile aseptic procedure, however Homerton has no allocated ‘clean’ ward for post-operative care of such patients.

“It would appear that Homerton is one of the very few hospitals in the UK which has no separate allocated ‘clean’ orthopaedic ward for joint replacement patients.

“Being a surgeon and not a rocket scientist, if the infection rate is 10 times – not just one and a half or two – than the national average, and somebody comes here and says there is nothing major that can be done, that lacks common sense.”

Non-executive director Polly Weitzmann said she was not reassured by the fact “no obvious reason” had been found for the high infection rates, saying: “One outstanding action is a dedicated ward – it’s the one big outstanding action rather than what you described as a series of measures.

“Because there is a problem, and if there is not an obvious reason it suggests some complexity that we are not on top of.”

Dr Claxton replied: “I can’t put my hand on my heart and say if there was a dedicated ‘clean’ ward that would definitely sort the issues out, but I would think that would minimise the risk, yes.”

A spokesman for the hospital said: “We regret each and every case of post-operative infection and take this matter seriously.

“This is why last autumn the Trust’s board called for a report on the situation to gain feedback on the action plan being put in place to avoid these infections occurring.

“As we have a relatively young population, we carry out small numbers of joint replacements compared to many other hospitals. But it means that a small spike in the numbers of post operative infections, as we had in 2013, impact on our returns to the national surveillance system.”