English hospitals under report SSIs

We thank Lamagini and colleagues for their interest in our paper. These authors from the HPA claim that we are misinformed and lacking in understanding. Yet, our criticisms are the same as those expressed by the Public Accounts Committee and the DH Advisory Committee on HCAIs. Even the European Centers for Disease Control says the English SSI surveillance system ‘lags’ behind the rest of Europe. The SSI surveillance data published by the HPA does not include post discharge surveillance (save for readmission data in the mandatory scheme) which account up to 80% of SSIs. This results in the ‘true’ scale of SSIs being hugely under reported. As length of stay after surgery continues to fall this becomes ever more important. An SSI surveillance system which does not include post discharge surveillance is akin to describing the size of iceberg by measuring only the part seen above the water.