A new report by safety investigators has laid out hospital hotspots for coronavirus in England.
The report by the Healthcare Safety Investigation Branch (HSIB) makes a series of observations to help the health service reduce the spread of coronavirus in healthcare settings.
Hospital hotspots for Covid-19 included the central nurses' stations and areas where computers and medical notes were shared, the HSIB found.
The investigation was initiated after a Sage report in May which found that 20% of hospital patients were reporting symptoms of Covid-19 seven days following admission - suggesting that their infection may have been acquired in hospital.
In response to the report, NHS England and NHS Improvement confirmed they would publish nosocomial - another term for hospital acquired infections - transmission rates from trusts, the HSIB said.
Analysis of the data reveals that dozens of patients a day could have been catching the killer virus in hospitals since mid-October.
Since October 12 there have been more than 100 cases reported each day across England.
An estimated 193 patients caught the virus while in hospital according to data reported on October 25.
The number of cases in hospitals have increased as community case numbers also rose.
But in the summer there were incredibly small case rates - sometimes with none in a day.
The HSIB investigation team visited six trusts to carry out observations and interviews.
They said that access to sufficient patient and staff testing and rapid testing "plays a key role" in how effectively NHS trusts can manage operational capacity.
Some trusts were seeking to create their own in-house testing facilities, they found.
The team highlighted how there was no regular surveillance testing for staff outside studies.
And they added that the potential risk of transmission by staff who are not showing Covid-19 symptoms was "not always well understood" at the trusts they visited.
Kathryn Whitehill, principal national investigator at HSIB, said: "The spread of coronavirus in hospitals presents a risk to patient safety.
"It also puts enormous strain on the workforce and the fear of contracting Covid-19 in hospital can deter patients from attending hospital who may need urgent treatment for other conditions."
The design of some hospital buildings also impacted on its ability to comply with guidance surrounding infection prevention control, the report adds.
The report sets out other safety recommendations including:
- A call for clear guidance to reduce the risk of hospital transmission .
- For the NHS to "support additional capacity for testing for NHS patients and staff" and "facilitates the accessibility of rapid testing for NHS trusts, as soon as an increase in rapid testing supplies becomes available".
- For the NHS to "respond to emerging scientific evidence and shared learning when reviewing guidance for NHS trusts on the role of hospital ventilation systems in nosocomial transmission."
Commenting on the report, Dr Layla McCay, director of international relations at the NHS Confederation, said: "This report reflects the concerns that we constantly hear from health leaders across the NHS, who are incredibly committed to meeting the challenges of infection spread in hospital.
"They tell us that guidance, especially around personal protective equipment, has been variable; Healthcare buildings and infrastructure need investment and modernisation to meet new infection control requirements.
"Access to testing for both patients and staff must be improved and staff, in addition to being at risk of Covid-19 infection, are facing exhaustion and burnout - which could worsen still further if nosocomial transmission is not controlled."
