Shropcom’s ‘diarrhoea bug’ infection rate concern ‘escalated’ up NHS chain

A board meeting of Shropcom was told that the trust is doing all it can to reduce the incidence of the bacterial infection which has already reached four in the trust this financial year.

The trust’s annual threshold alert level is four and the rolling 12-month figure is 12, the board was told.

Clair Hobbs, director of nursing, quality and clinical delivery at Shropcom, said the most recent infection had occured last weekend, following three ‘hospital acquired C diff cases’ in April.

“I have taken it to the system level,” Ms Hobbs told the meeting in Oswestry on Thursday (June 5). “We are doing everything we can, I am overseeing every case and I will keep banging the drum.”

The board was told that there is a programme of deep cleaning in progress but they are now looking at ‘deep dives’ to see if that cleansing is being carried out to its fullest, including by taking radiators off walls to reach any infection nooks and crannies.

“We have gone as far as we can but I will keep pushing,” said Ms Hobbs. “It is a tricky one for us and very challenging.”

A report to the board said that nine C diff cases in for 2024/2025 included five in Ludlow, one in Bishop’s Castle and one in Whitchurch. There was also one in ward 18 at Royal Shrewsbury Hospital, which is a rehabilitation and recovery unit (RRU), and one in ward 36 of Telford's Princess Royal Hospital, also an RRU.

The board was told that the three cases in April 2025 included two in Telford's Ward 36.

The two RRUs were opened last year for people who no longer need to be in an acute hospital bed but can’t be supported safely at home. The care at the units is delivered by Shropcom.

Andrew Morgan, Chair in Common of both Shropcom and The Shrewsbury and Telford Hospital NHS Trust (SaTH), told his colleague that her concerns are supported by the Shropcom board.

“Our board is concerned,” he said. “Somebody needs to do something. You have the full backing of the board.”

The board heard that the C diff bug can hang around but that “once you get rid of it, it’s fine".

A Quality and Safety Report to the board showed that Shropcom’s rolling 12-month C diff infections now stand at 12.

The report said that a “post-infection review” is completed for each case with many patients having been on multiple courses of antibiotics for other infections identified as the most probable cause.

Reviews so far say that 50 per cent of the cases were re-lapses of infection that they had had previously. They are also looking at de-prescribing drugs which are known to increase risk of developing C diff when they are used long-term.

The report says that a Shropcom unit in Whitchurch was deep cleaned in July 2024 and that Ludlow, Bishop’s Castle Community Hospital and Bridgnorth have had bay-by-bay deep cleans following recent outbreaks. A plan is in place for the community hospitals in 2025/26.

The NHS website says that C diff is a type of bacteria that can cause diarrhoea. It often affects people who have been taking antibiotics. It can usually be treated with a different type of antibiotic.

C diff bacteria usually live harmlessly in your bowel along with lots of other types of bacteria, says the NHS website. But sometimes when you take antibiotics, the balance of bacteria in your bowel can change, causing an infection.

“When someone has a C diff infection, it can spread to other people very easily if the bacteria found in the person’s poo get onto objects and surfaces,” it adds. “C diff infections can sometimes lead to more serious problems like sepsis.”

The NHS website says if a C diff infection comes back two or more times, patients may be offered a faecal microbiota transplant. This is where bacteria from a healthy person’s poo is put into your gut to help stop the infection.

This can be done by taking a poo capsule.

Shropshire Community Health NHS Trust runs services across the county in a range of different locations. The trust runs four community hospitals – in Bishop’s Castle, Bridgnorth, Ludlow and Whitchurch – as well as the Oswestry Health Centre.