PatientPak

Sanitas Healthcare plc (formerly PatientPak Holdings Ltd) is a consumer hygiene pack manufacturer and retailer. The original product, PatientPak, was designed for use by patients to protect themselves from healthcare-associated infections (HCAIs), and especially from antibiotic resistant pathogens known as ‘superbugs’, when they go into hospital. The ‘Pak’ contains a range of antimicrobial products in the form of wipes and sprays as well as various hygiene and convenience items, such as soap and nailbrush. According to test data, the patented formula is proven to kill 99.99% of germs such as MRSA (methicillin-resistant Staphylococcus aureus), Norovirus, Avian Flu (H5N1), Salmonella and E. coli. It is tested and successfully meets the requirements of the EN1276, prEN12054, EN1500 and EN1275 European antimicrobial standards. PatientPak was introduced to the UK market in October 2008.

Sanitas Healthcare plc introduced in October 2009 four new products proven to kill the latest strain of swine flu. They are:

• FluPak

• ProtectGel

• ProtectSpray

• ProtectWipes

These are initially available throughout the Lloyds Pharmacy chain.

History
The idea behind PatientPak emerged in 2006, when an elderly lady preparing for a stay in hospital asked a friend how she could best protect herself from infection while admitted. They were dismayed to find that there were no commercially available products which would be effective against superbugs such as MRSA. After carrying out considerable research, they selected the most efficacious clinical product available, and repackaged it as a consumer hygiene pack. Over more than two years since then, an extensive research, development and testing programme led by the company’s Founder and CEO, Rob Gros, has produced a variety of antimicrobial products including PatientPak launched in September 2008 and FluPak launched in September 2009.

PatientPak product contents
• Antimicrobial Sanitising Wipes

• Antimicrobial Hand Sanitising Spray

• Antimicrobial Fabric Spray

• Antimicrobial Hair and Body Wash

• Soap

• Nail-Brush

• Face and Body Wipes

• Toothbrush

• Toothpaste

• Lip Balm

• Pen

• Infection-Control Guide

• ‘Polite notice’ from MRSA Action UK

Other Sanitas Healthcare products
FluPak, containing:

• Sanitising Wipes x15

• Sanitising Spray 60ml

• Tissues

• Disposable Bag

• Good Hygiene Guide

ProtectGel – a sanitising hand gel

Lloyds Pharmacy stocks FluPak and ProtectGel exclusively.

Other products from Sanitas Healthcare include:

ProtectPak, containing:

• Antimicrobial Sanitising Gel

• Antimicrobial Hair and Body Wash

• Antimicrobial Sanitising Wipes

• Antimicrobial Body and Face Wipes

• Antimicrobial Soap and Dish

• Pen

• Bag

• Guide to Good Hygiene

• Polite Notice

ProtectSpray – to sanitise fabrics and furnishings

ProtectWipes – for sanitising hard surfaces such as handles, tabletops and telephones

Healthcare Associated Infections (HCAIs)
Healthcare Associated Infections (HCAIs), in particular ‘superbugs’ like MRSA, have become a growing problem for health authorities in the UK over the last few years. MRSA was relatively uncommon through the 1960s and 1970s. The infection rate rose dramatically in the mid-1990s when particular 'epidemic' strains of MRSA became established in hospitals throughout the UK. These strains are easily transmissible (passing between and colonising both patients and hospital staff) and can cause serious disease. 6,381 cases of MRSA were reported in England between April 2006 and March 2007. According to The European Antimicrobial Resistance Surveillance System (EARSS), which collates HCAI infection data from across Europe, the UK has the 4th highest rate of MRSA in Europe after Portugal, Malta and Greece.

Current estimates of the rate of healthcare associated infections among hospital in-patients in England range from 8.2% to around 10%. It costs the NHS between £4,000 and £10,000 more to treat a patient with an infection, and about £9,000 more to treat a single patient with a superbug infection.

Aims of the product
PatientPak is advertised as having several aims. Chief among these is the idea that the product allows hospital in-patients, who often feel powerless over what happens to them in hospital, to protect themselves. PatientPak are at pains to make clear that while they realise the health services are working hard to cut infection rates, patients can nevertheless contribute to the solution.

Another of PatientPak’s aims is to raise awareness of the problem of healthcare associated infections and how patients and visitors can contribute to the solution by providing infection-control and hygiene advice. Each PatientPak includes a guide to good hygiene, in the form of an advice leaflet explaining how best to combat superbugs, viruses and bacteria. There is also a bedside notice, which politely requests NHS staff to wash their hands before treating the patient.

Testing and development
The antimicrobial formula contained in PatientPak mediates against resistance by ensuring the widest spectrum of activity; the synergistic mix of quaternary ammonium compounds and the polymeric biguanide each have a completely different mechanism of action. According to the clinical test data, it is proven to kill 99.999% of germs such as MRSA, Norovirus, Avian Influenza (H5N1), E. coli, Salmonella, Hepatitis B and C and Campylobacter and is tested in accordance with EN1276, prEN12054, EN1500 and EN1275 European antimicrobial standards.

Use in the NHS
Clinell, the name of the antimicrobial formulation contained in the sanitising wipes, hand sanitising spray, fabric spray and hair and body wash, is extensively used throughout the NHS. Clinell products were submitted to the Health Protection Agency’s Rapid Review Panel in December 2007 and achieved a recommendation 2. The RRP stated that ‘in use evaluations/trials are now needed in an healthcare setting’.

Attention in the UK Parliament
While Sanitas Healthcare’s PatientPaks are the only known ‘anti-superbug’ kits on the UK market, they fall within the more general category of ‘personal antimicrobial products’. During the current 2008-9 session of the UK Parliament, two Early Day Motions (EDMs) were tabled by MPs calling on the NHS to supply a comprehensive range of personal antimicrobial products to every hospital in-patient as a cost-effective means of reducing healthcare-associated infections.

EDM 348, tabled by Mike Hancock MP and signed by 22 other MPs, states:

"That this House regrets that the best estimate the Government has provided for the cost to the NHS of treating and preventing healthcare associated infections (HCAIs) is based on data that is 14 years old; notes that recent reductions in superbug infection rates are modest drops from record high levels; understands that the NHS is considering providing infection-control packs to only those patients who already have MRSA; regrets that such measures are designed to deal with infection rather than prevent it; further notes that it costs up to £10,000 more to treat each patient that contracts an HCAI, which affect an estimated one in 10 patients, and that in consequence the NHS spends up to £1,000 per in-patient on treating HCAIs irrespective of whether the in-patient contracts an infection; believes that, in order to prevent HCAIs, it is essential that the NHS provides a comprehensive range of proven personal antimicrobial products and a guide to infection control to every NHS in-patient; calls upon the Government to, at the very least, undertake widespread trials of such an initiative, report the findings to the House and extend the initiative throughout the NHS if the trial is successful; and recognises that this preventative scheme, if implemented, would cost a small fraction of the amount spent on HCAI treatment."

EDM 356, tabled by Bob Spink MP and signed by 24 other MPs, states:

"That this House is concerned that, despite recent falls, infection rates of MRSA, C. difficile, Norovirus and other superbugs remain high, and there is considerable public anxiety about this issue; notes that as everyone can carry and spread superbugs, patients and visitors as well as hospital staff have a part to play in helping to tackle infection; believes that patients should individually be provided with the means and information to protect themselves and others when they go into hospital; and calls upon the Government to provide a comprehensive range of personal antimicrobial products that are proven to kill superbugs and a hygiene guide to every NHS in-patient prior to admission, or as soon after admission as possible as this will help reduce infection rates, empower patients and instill good hygiene practices at a fraction of the financial cost of treating those who contract superbugs."

In addition to the Early Day Motions, several Parliamentary Questions (PQs) have been tabled in the House of Commons asking about the possibility of the NHS providing personal antimicrobial products to be supplied to hospital in-patients.

Advertising and marketing
PatientPak is aimed at hospital in-patients, hospital visitors, and other groups vulnerable to infection such as pregnant women and new mothers, those recovering from injury or surgical procedures, and the elderly. PatientPak was advertised between December 2008 and February 2009 on the London Underground network, with the strapline “The battle against superbugs just got personal.” Four different adverts were used, featuring variously photographs of a pregnant woman and her daughter, a young child, an old man and a younger, sporty man. Slogans included “Just bug off”, “I’m going to wipe you off the face of my earth”, “Talk to the hand”, and “I’m going to wipe the floor with you.”

Media coverage
PatientPak received a great deal of critical media attention on its launch in October 2008, with articles and pictures in several major UK newspapers, including The Sun, The Daily Mail, The Times, The Daily Telegraph, The Independent and the London Metro.

Involvement with MRSA Action UK
Sanitas Healthcare is working with MRSA Action UK, a hospital standards pressure group. Derek Butler, the Chairman of MRSA Action UK has said: While the NHS cannot guarantee to prevent patients contracting an avoidable healthcare infection, patients will look to prevent themselves from contracting healthcare infections by using items like PatientPak. MRSA Action UK believes that preventing patients contracting avoidable infections is always the best solution."

View from the scientific community
Professor Richard James, Professor of Microbiology at the University of Nottingham and Director of the Centre for Healthcare Associated Infections, has voiced support for PatientPak and is quoted on the company’s website: This convenient PatientPak kit is a good idea and offers excellent protection against hospital superbugs and viruses. I would give it to my own relatives who are going into hospital, as it’s far more valuable than a bunch of flowers.

Professor Steve Field, Chairman of the Royal College of General Practitioners, said the kit, which includes hygiene sprays, wipes, soap, lip balm and a disposable toothbrush and pen, was "a complete waste of time for patients in the NHS It’s nonsense. It’s wrong to exploit the vulnerable, particularly when they are ill, frail and infirm. I would recommend that patients considering buying this go and buy some fruit instead.”"

Dr Peter Carter, General Secretary of the Royal College of Nursing, said: "It is irresponsible and potentially dangerous for PatientPak to even suggest that their product will do anything to tackle healthcare associated infections. The fact that this company openly targets two of the most vulnerable groups of NHS users – older people and pregnant women – is deeply worrying and entirely misleading."