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1.
How can it be that natural, holistic methods for infection control such as sterile Manuka honey wound dressings and cream, or silver-impregnated wound dressings are now approved for use by the DoH and NHS- but they do not have the authorisation of the MHRA? Please clarify this. Is it not necessary?
2.
Can the DoH continue to justify their statement to me that “consequently the use of UV treatment or changing ventilation is unlikely to have a significant impact”? (This was the view of an MRSA Policy Adviser in June).
Actually I have found that many international experts consider that the reverse is more likely. It is standard practice e.g. in research labs and path labs to use portable UV lamps to disinfect contaminated surfaces. UV lamps are even routinely built into fume cupboards. UV equipment may be expensive but it could save lives and a huge drugs bill if local directors of infection control and prevention are reminded that this option is available.
3.
Since bacteriophage therapy is now approved in Poland by their Bioethics Committee for HAIs and MRSA etc., please can you confirm that since Poland is part of the EU, the UK could use phage therapy under EU law - at least as an option to the conventional antibiotics. Could our NHS patients be offered the option to travel to Poland? - the treatment is so successful.
I look forward to hearing from you at your earliest convenience.
Our ref: DE6009240
Dear Ms Filby,
Thank you for your email to the Department of Health about the change of
spelling from methicillin to meticillin. Your email has been passed to me
for reply.
I can confirm that meticillin and not methicillin is now the standard name
for this generic antibiotic in Great Britain. This is due to the risk of
errors in international prescribing from country to country without a
uniform standard. The UK used to conform to a system called 'British
Approved Names' (BANs), but there was an element of confusion with this
when prescribing abroad for non-British health professionals. It was
recommended by the Medicines Commission that the UK adopt the international
standard, known as 'recommended International Non-proprietary Names'
(rINN), to avoid confusion.
I have provided a link to the relevant press release below:
http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4075150&chk=k96yFB
I hope this information is helpful.
Yours sincerely,
>>>>
Customer Service Centre
Our ref: DE6015540
Dear Ms Filby,
Thank you for your email of 7 June about alternative methods for combating
meticillin resistant Staphylococcus aureus (MRSA). Your email has been
passed to me for reply.
The Government is always interested to hear of effective new healthcare
products and ideas. However, you will understand that the Department
cannot endorse specific items. Before a new product or idea could be
introduced to the NHS, there would need to be an evidence base that it did
prevent infection, and did not have any adverse effects on patients. As
you know, to help the NHS make such assessments, a rapid review process has
been convened by the Health Protection Agency (HPA) to review proposals
designed to aid hospital infection control.
The Rapid Review Panel (RRP) reviews proposals received or identified by
the Department to prevent or control HCAIs. 78 item reports are currently
displayed on the Health Protection Agency's website and are the results of
four RRP meetings. You mentioned that the ideas you discussed are outside
the remit of the RRP, but in the report below, it does have a heading under
'air decontamination products' called 'Fresh Air-UV Air Filter'. If you
have not already seen them, these reports can be accessed at:
http://www.hpa.org.uk/infections/topics_az/rapid_review/reports.htm.
In March, then Health Minister Melanie Johnson said: "The scientific
literature indicates that essential oils can help control
healthcare-associated infections, including methicillin-resistant
staphylococcus aureus [MRSA].
The department has allocated £3m to research into healthcare associated
infection and has recently issued a call for research proposals."
Therefore, you may wish to send detailed information, particularly the
results of external studies including clinical trials, to:
The Inspector of Microbiology and Infection Control
The Department of Health
Room 357C
Skipton House
80 London Road
London
SE1 6LH
Although common sense suggests there is an association between cleanliness
and HCAIs including MRSA, we do not have a strong scientific evidence base
to prove the link. The Department of Health is therefore working to
improve not just cleanliness, as you mentioned, but also infection control.
The Government is making considerable research investment in the area of
bacteriophages. The database of the Biotechnology and Biological Sciences
Research Council (www.bbsrc.ac.uk) lists 105 grants and studentships. In
addition, the Medical Research Council (www.mrc.ac.uk) has funded a project
at the Institute of Child Health, London, to investigate the potential of
bacteriophages for the treatment of staphylococcal infection.
The Department of Health keeps its priorities for research under review.
Priorities for departmental research and development support for the
development of policy are determined through discussion with policy
officials and Ministers. In the NHS priorities are identified through
widespread consultation with those using, delivering and managing services.
They take account of the burden of disease, potential benefits and the
Department's objectives as well as the responsibilities and work of other
funders - including charities.
I can assure you that the Government is committed to tackling all
healthcare associated infections (HCAIs), including MRSA, as a key
priority. Ministers are determined to ensure that the hospitals in which
patients are treated are of a high standard, with well-trained and highly
motivated staff, and that the environment in which patients are treated is
safe.
Unfortunately, not all HCAIs are preventable and many factors contribute to
the problem. For example, more patients who are susceptible to contracting
infections are being treated than ever before, such as patients with severe
or chronic diseases. Advances in treatments that improve patient survival
can at the same time leave them more vulnerable to infections.
You have obviously put a lot of work into your research and I thank you for
taking the time to write to the Government.
Yours sincerely,
>>>>
Customer Service Centre
Department of Health
> Our ref: DE6015962
>
>
>
>
> Dear Ms Filby,
>
> Thank you for your further email, dated 13 June, to my colleague, Vanessa
> Starkey, about bacteriophages. This has been passed to me for reply.
>
> Phages are not a new concept in scientific terms. However, their possible
> usefulness in a medical context is limited by the fact that they have
> narrow spectrums and are bacterium specific. That is, a specific phage
is
> needed for a specific organism.
>
> As my colleague explained, the Government is currently funding research
in
> this field. This research is ongoing and, as yet, has not yielded any
> conclusive results.
>
> I am sorry that neither I nor my colleagues can give you any more
> information on this subject at present. Nevertheless, I hope the
> information I have been able to provide has been of interest to you. Thank
> you for writing to the Department
>
> Yours sincerely,
> > > >
> Customer Service Centre
> Department of Health
>
|
FACT: UV and sunlight kill germs demonstration - |
Full evidence base via http://www.relax-well.co.uk/Light_Revolution.html
And another visual aid as a stark contrast.
> Thank you for your further email, dated 13 July, to the Department of
> Health about phage therapy.
>
> As I explained previously, research into this subject is ongoing and,
> currently, there is no further information available to offer you. After
> thorough consideration of the facts, I am afraid that the Department has
> nothing further to add to previous replies.
>
> I am sorry to have to give a disappointing answer, but we must now consider
> this matter closed.
>
> Thank you for taking the time to write to the Department.
>
> Yours sincerely,
> > > >
> Customer Service Centre
> Department of Health
The Reply from the Department of Health: 22.9.05 including
the new situation re. phage therapy is at
the top of this page.
----- Original Message -----
From: <Christine Beasley>
To: <Grace Filby>
Sent: Wednesday, July 20, 2005 3:14 PM
Subject: Re: one of your letters
Dear Ms Filby
Thank you for your e-mail to CMO and myself on the subject of measures to
control the spread of MRSA. I am responding on CMO's behalf as well. As you
know, it is one of my top priorities to improve levels of hospital hygiene
and reduce the risk of healthcare associated infections (HCAIs).
The most recent information about the measures that are being implemented
can be viewed on a dedicated website at www.dh.gov.uk/reducingmrsa This
includes a new toolkit for hospital trusts, 'Saving Lives: a delivery
programme to reduce Healthcare Associated Infection including MRSA'.
Existing guidance already covers the provision of treatment in isolation
from other patients where appropriate.
I would like to assure you that we are actively setting out to improve the
research evidence underpinning infection control practice. The government
has committed £3 million extra to support R&D into healthcare associated
infection. We sought proposals earlier this year to evaluate the impact of
interventions to reduce the risk of HCAIs and are currently considering the
more than 70 proposals received.
The rapid review panel provides a means by which new processes and products
can receive a quick scientific review of their merits. These reviews are
published and disseminated regularly to NHS Chief Executives and Medical
Directors, to advise them of the latest developments and to enable them to
make decisions about purchasing for local implementation. One of the top
rated products, a new two hour test for MRSA, is being trialled at three
NHS trusts.
I hope you will find this information helpful.
Yours sincerely
Christine Beasley
Chief Nursing Officer
From: <Grace Filby>
To: <Christine Beasley><Liam Donaldson>
Sent: 24/06/2005 14:57
Subject: one of your letters
Hello,
A colleague at the Rapid Review Panel has kindly offered your email
addresses so I hope this is acceptable to contact you directly.
I am enquiring about one of your letters online at
http://www.dh.gov.uk/assetRoot/04/11/25/90/04112590.pdf - Mandatory
Surveillance of Methicillin Resistant Staphylococcus Aureus (MRSA)
Bacteraemias.
There are one or two things I'd like to check as part of my research.
1. It says that the DOH is currently implementing a raft of interventions.
Exactly how big is this raft? Is there enough space on this raft yet for
phage therapy, essential oils, vitamin C, garlic, ozone, UV light, clean
air filters/ducting and more (not just asking people to submit proposals
for more research or commercial products to the RRP) because the research
has been done - the evidence has not yet been coordinated and incorporated
into policy reviews.
The following comment is from our local Hospital Trust's Consultant Medical
Microbiologist & Director of Infection Prevention & Control. I think
it
indicates that they would like to adopt some more holistic interventions,
but it would be for the Dept of Health to proactively and urgently show
their support for the efficacy and safety of this type of remedy, so that
local policy makers can make informed decisions.
"Our local policy decisions have to be made carefully and justifiably,
and
in the light of national evidence-based guidance which, currently, does not
exist for these modalities in this context."
Dr Bruce A.Stewart
Even if the official view by one of the MRSA Policy Officials is that these
"may be beneficial in some circumstances as part of a complete system for
prevention and control" at least that comment made publicly would be a
real
constructive step forward, and better than doing or saying nothing helpful
about them. In comparison, it doesn't sound very scientific or
evidence-based when members of the public are merely informed that
"Inadequate hand hygiene is believed to be the main transmission route
for
MRSA", as if nothing else matters.
At the moment everything seems to be held up with loads of 'red tape' or
lack of vision. There is plenty of evidence about alternative approaches
out there, and even another suggestion for you about side rooms that you
hadn't even thought of.
I hope you would feel that this would be worth thinking about and I would
be delighted to be invited to explain it to you.
My idea (Patent Office appln. no 0512044.9 Filing date 14-Jun-2005) would
help you make TEMPORARY ISOLATION AREAS without any of the disadvantages
that the 6 top microbiologists are worried about. You are probably familiar
with that correspondence
http://www.timesonline.co.uk/article/0,,59-1509376,00.html.
2. I was rather intrigued and also amused by the very last sentence on page
5:
"This flow of information and bacteria for reference investigation should
continue." Would this be better re-phrased? I thought the Dept of Health
was supposed to be stopping the flow of bacteria?
Kind regards
Grace Filby
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