Proposal to stop routine post-discharge MRSA colonisation letters

Dear Colleagues,

I am writing on behalf of the Infection Prevention Team at Homerton University Hospital NHS Foundation Trust to seek your views on a proposed change to how we communicate MRSA colonisation results identified during hospital admission.

At present, we routinely issue letters to both patients and their GP when an MRSA screening result becomes available after discharge. Following review of current national guidance, clinical impact, and the operational burden of this process, we feel this approach may no longer be proportionate or clinically necessary for asymptomatic colonisation.

The latest joint guidance from the Healthcare Infection Society and Infection Prevention Society (2021) recommends that patients are informed of results and that appropriate documentation and management processes are in place. However, it does not mandate routine written GP notification or post-discharge letters for MRSA colonisation. For most patients, colonisation is asymptomatic, requires no treatment in the community, and does not alter routine primary care management.

In addition, our Trust operates universal/risk-based screening on admission, meaning colonisation will be identified and managed appropriately at future healthcare contacts. We have found that routine retrospective letters often provide limited additional clinical benefit while creating significant administrative workload and potential information-governance risks associated with written communication of sensitive results.

We are therefore considering the following approach:

• Inform patients of MRSA results during admission wherever possible
• Clearly document and flag results within the electronic patient record for future admissions
• Contact Primary Care only where clinically indicated (e.g. active infection, treatment required, or specific risk-based circumstances)
• Discontinue routine letters for asymptomatic MRSA colonisation

Before implementing any change, we would really value your feedback to ensure the process supports Primary Care effectively. In particular:

• Do you find routine notification of MRSA colonisation useful?
• How is this information used within your practice (e.g. coding, flagging, treatment decisions)?
• Would you normally inform patients yourselves, and are there any information-governance considerations we should be aware of?
• Is there a preferred method or format for communication when notification is clinically required?

Our aim is to ensure communication is meaningful, proportionate, and supports safe, joined-up care without generating unnecessary workload.

We would be grateful for any comments or concerns and are very happy to hear your feedback or discuss further by contacting Julie.singleton2@nhs.net.

Kind regards,

Julie

Ms Julie Singleton | MSc (PH) BSc (IPC) RGN

Head nurse, Infection Prevention Control (IPC)

Deputy DIPC

Homerton Healthcare