The sterilization of Britain’s endoscopes is revealed as haphazard and lacking, in a survey unveiled today by the Patients Association to MPs and Peers in the House of Commons.

The poll, among healthcare professionals, reveals that five per cent of those questioned didn’t clean their instruments between patients; more than a half reuse the sterilising fluid; many endoscopes never make it to the Central Sterile Department at the end of each clinic; and there are no uniform guidelines on who is responsible, or just what they should do.

The poll also shows that 35 per cent of those questioned had never even heard of the Chief Medical Officer’s 2003 report “Winning Ways”, which identified intensified control measures as essential to defeat healthcare associated infection.

The Patients Association survey was conducted among NHS trusts’ infection control staff, consultant microbiologists, senior clinical nurses, consultant gastroenterologists, decontamination managers, Central Sterile Services Department managers, risk managers, charge nurses, and theatre managers and staff in endoscopy units throughout the UK in October 2004.

A total of 1496 questionnaires were sent nationwide, and 180 replies received, from 53 per cent of English NHS Trusts – but none from Scots or Welsh units.

It was designed to reveal the infection control and decontamination practices of medical devices, and showed that 96 per cent of the respondents rank this high on their priority list, and 95 per cent say they sterilize the endoscopes after each patient use. However:

· Standards vary on who is responsible for sterilisation – 51 per cent stated the endoscope nurse, but one in three said the healthcare assistant and 19 per cent said either another nurse or even someone else who was not a nurse

· Between 60 and 70 per cent of respondents indicated that they re-used the sterilizing agents after each patient. The primary reason for re-use is the claim that effectiveness remains the same, secondly because of Trust policy, followed by the cost of alternatives. One respondent said it was due to the unpleasant odour of the re-useable agents

· A full 80 per cent of respondents said they do not send the appropriate endoscopes to the Central Sterile Department for sterilizing at the end of each clinic

· There is currently no test for vCJD, yet one respondent thought there was, and it was in use

The survey also asked if patients were informed about infection control, and 68 per cent of respondents said “no”, or only if requested.

Three per cent of respondents said there was no education and training for the infection control of endoscopy procedures, and four per cent do not know if education and training have been implemented.

Claire Rayner, President of the Patients Association, said: “Even this limited survey reveals a picture of haphazard systems and standards in what should be one of the most rigidly policed area of decontamination. There is clearly enough evidence here to prompt a full survey, including Scotland and Wales, and standardise best practice.

“We hope that the results and the issues raised at the meeting on infection control and medical device decontamination in the House of Commons will stimulate further debate – transformed into real action – about the vital need to minimise the risk of infection to patients undergoing invasive procedures.”

Shadow Health Secretary Andrew Lansley CBE MP, who is hosting the event said: “The Patients Association survey highlights a vital issue. The rules of invasive procedures and the standards of decontamination of equipment can have a major impact on a patient’s exposure to infection.

“Publishing reports from the Department of Health must be accompanied by action in hospitals if we are to achieve the standards of safety and cleanliness which patients rightly demand.

“I welcome the Patients Association’s work in representing patients’ interests in delivering cleaner hospitals.”