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Hospital bosses say it will take 11 years and £13m to fully fix the problems that led to a superbug outbreak which killed three people.

Arrowe Park Hospital, in Birkenhead, has been battling to bring the rates of bacterial infection clostridium difficile (C-diff) under control since an outbreak earlier this year.

Wirral University Teaching Hospital NHS Foundation Trust (WUTH), which runs the hospital, cracked down on what it identified as poor infection control practise, a shortage of time for proper cleaning and run down wards.

Managers have taken a number of short term measures including ordering more than 1,000 pieces of new furniture, including chairs and bedside tables for patient areas.

The trust says it has seen the number of infections drop and it has been officially out of 'outbreak' status since the beginning of October.

(Image: Liverpool Echo)

However the root causes of the deadly outbreak, which caused two deaths in January and one in May, will take a major scheme of rolling maintenance and millions of pounds to address.

Arrowe Park has overhauled its cleaning and maintenance departments, changed and strengthened its policies and a conducted wide ranging investigations into what went wrong.

The results make for worrying reading, with problems including:

Mattresses contaminated with bodily fluids

Equipment and furniture shared between patients that was damaged and hard to disinfect

Delays in sample taking for patients with suspected C-diff infections

An audit of 85 commodes revealed only 36 were clean and in a good state of repair

Failure to quickly isolate patients with C-diff meaning they were receiving treatment in open wards

The biggest issue for bosses, and the most difficult to address, is the poor state of repair of many of the hospital's wards.

(Image: Arrowe Park Hospital)

A joint report by senior nursing and maintenance staff, presented to the WUTH board in August, noted: "Whilst there has been great improvements made following the interventions implemented at Arrowe Park in recent weeks to reduce the risk of cross infection from clostridium difficile, one of the most important aspect has yet to be addressed; improvements to the fixtures and fittings of the patient environment in the Hospital.

"It has to be recognised that most of the wards are outdated, overdue life-cycle replacement and no longer meet legislative requirements."

Following high level meetings, a plan to address the issue has been rolled out involving cycles of maintenance.

The first wave of improvements, which are most urgent to reduce infection risks, involves minor works including removing and replacing mouldy sealant from hand wash basins, fixing ceiling tiles and walls, removing signs, charts and noticeboards from clinical areas and removing tissue and handgel dispensers.

This first stage, costing around £5,000 per ward, will take around 60 months to complete.

The second level of improvements includes upgrades to flooring and skirting, resealing windows, and upgrading sluice and storage rooms, and is expected to take around seven years to fully complete.

The third and most comprehensive wave of improvements includes extensive upgrades to wards including bathrooms, showers, ceilings windows, pipework and flooring.

The final stage of upgrades is predicted to take four months per ward, with each ward needing to be emptied, at a cost of £405,000 per ward.

C-difficile infection, which takes hold in the bowels causing diarrhoea and fever, is particularly dangerous to elderly or sick patients and usually occurs in people taking antibotics.

Outbreaks were recorded in five wards of the Birkenhead hospital and the trust recorded 78 infections in the 2018/19 period, including 44 found to have been "avoidable."

According to the report testing has revealed the outbreak is linked to a "particularly virulent strain associated with more severe infection."

The rate of infections has risen sharply since 2016/17, when 35 cases were recorded.

The trust says infection rates for September and October are much improved, but Public Health England has "advised caution as they anticipate the trajectory may be not be linear."

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Paul Moore, acting chief nurse at the trust, told the ECHO: " An enormous effort has taken place by staff over the past few months meaning we’ve been out of outbreak status since the start of October.

"We are not complacent and remain vigilant as this has been an extremely virulent strain of Clostridium difficile.

"Over 1,000 items of new equipment, including bed side chairs and tables, patient lockers and visitor’s chairs have been replaced throughout our wards to strengthen infection prevention and control.

"In addition to this new furniture, we have worked closely with our domestic staff by reorganising workflows so that more effective and additional cleaning takes place where it needs to happen.

"The Board have also agreed a range of options to improve the clinical environment for patients as part of a comprehensive capital programme.”

Highlighting what the public can do to help, Mr Moore added: " It is vital that members of the public and others visiting the hospital play their part in protecting vulnerable people from infection.

"We ask that visitors please use soap and water when entering wards and to also use the hand gels provided throughout our hospitals."