Maidstone and Tunbridge Wells NHS Trust might not seem a promising reference point for hospital cleaning and hygiene standards. Following revelations by an under-cover BBC reporter about cleaning at Tunbridge Wells in 2004, the trust experienced the UK's worst outbreak of C-Difficilein 2005 and 2006. The resulting Healthcare Commission investigation, published October 2007, was highly critical and resulted in the resignation of the Chief Executive, Chairman and most board members.

But as is often the case, beyond the ‘Dirty Hospitals' headlines, things are not as simple as they might at first seem. Domestic Services are not centralised within the Trust. Cleaning at Maidstone Hospital is managed in-house by the Domestic Services department and was the only hospital in the trust using Clematis at the time of the outbreak. By far the strongest criticism about hygiene standards was directed towards two other hospitals in the trust and Maidstone had escaped the worst of the C-Difficile outbreaks.

Some of this was undoubtedly due to the more modern design of the hospital, in particular the better spacing of beds. But Barry Parker who was Domestic Services Manager at Maidstone Hospital at the time of the outbreaks is in no doubt that Clematis played a key role in the higher standards of cleanliness Maidstone hospital achieved.

"I have a complete set of reports every week showing me what has been used in every ward" said Parker. "I can compare this with the same period in past years to see how things have changed. This really helps to identify where something may be going wrong if, for example, the use of a particular item changes in a specific ward. It also makes re-ordering easy as I have a totally accurate and up-to-date picture of what has been used, the usage rate and what remains in stock."

Maidstone Hospital Domestic Services have been using GreenValet's Clematis since 1997 to manage the consumption of cleaning products and materials. With a substantial cleaning materials budget and limited storage space it is essential to have a well organised and efficient operation. Deliveries of bags and other cleaning products are normally made weekly into the small stores area. Everything is entered into Clematis and as cleaners use items they are logged out on the dedicated keyboard.

Answering one of the first criticisms of the investigation, cleaning materials are available round the clock. This is achieved by means of a strategically located ‘vending machine' linked in to the Clematis system. This also avoids the need for wards to keep a ‘stash' of materials such as bags for out of hours use.

Barry Parker loves the system. But he also makes the point that Clematis doesn't work on its own "...someone must be responsible for making sure the ‘dispensing' data is entered to get the benefits".

It was during the C-Difficile crisis that the strength of Clematis was fully demonstrated. One of the areas of to come under the Commission's spotlight was the availability of cleaning materials such as disinfectants, mops, cloths, scourers and bags. A number of allegations were made in the press suggesting that cleaners hadn't got the materials they needed.

Clematis enabled Parker to refute the allegations completely and prove to the commission beyond any doubt that stocks were available throughout the outbreak. "I could show we had stocks, had not run out of every item at any point in time and had never run out going right back across the period of the outbreak and before. I could show them what had been issued to each ward. The investigators were really impressed with the level of detail Clematis provided showing exactly where all the cleaning material were used ".

Barry Parker would advise all Domestic Service managers to install Clematis, not just as an insurance against the possibility of a C-Difficile outbreak and subsequent investigation. He values it for the fact that he gets detailed weekly and monthly reports without having to employ someone to keyboard data. It enables him to manage a complex cleaning operation efficiently.

He cites the fact too, that he has never experienced any budget problems: "When it comes to setting the purchasing budget for the next year the purchasing manager knows that I have a complete record of consumption and can justify all my spend down to the last penny."