This UK hospital bans hand-washing, removes sinks — it’s to protect people from infections

At Wexham Park Hospital in Slough, Intensive care unit advisor Dr Karim Fouad Alber had a couple of questions when he and his colleagues had been requested by his hospital to start out washing their palms much less.

“I had a number of questions,” he recalled whereas talking to The Telegraph.

The primary sounds fairly affordable. “Whether or not (not handwashing) was going to be clear sufficient for the sterile procedures that we had been doing?” he requested.

For a time, he merely saved washing as regular — till the sinks had been taped over, after which eliminated fully.

Over the previous yr, 23 sinks have been taken out of the hospital’s ICU and 108 eliminated throughout 9 wards, together with aged care and oncology. Ultimately, as a lot as 80% of all sinks on the positioning could disappear, leaving solely these in bathroom services. At Wexham’s sister website, Frimley Park Hospital, even neonatal items are slated for sink elimination.

The transfer could sound counterintuitive — particularly after years of public-health campaigns urging vigilant handwashing — however Wexham Park is the primary hospital within the UK to undertake a “water-safe” mannequin, impressed by rising practices within the Netherlands and Germany, reported The Telegraph.

The technique’s architect, advisor medical microbiologist Dr Manjula Meda, insists the goal is to not cut back hygiene however to get rid of a hidden, highly effective supply of antimicrobial-resistant micro organism: hospital plumbing.

Dr Meda defined that sinks, drains and wastewater pipes act as “reservoirs of micro organism… an Amazon rainforest in drain methods.”

When folks wash their palms — usually inadequately — microbes enter drains, flourish in heat, nutrient-rich pipes, and develop extra resistant when uncovered to antibiotics excreted in urine.

“These bugs are utilizing drainage methods as a superhighway,” The Telegraph quoted her as saying.

Research present a sink’s splash zone can lengthen two meters. Strain adjustments in pipes can push bacterial “plumes” again into the air. In environments stuffed with susceptible sufferers, reminiscent of ICUs, this creates a harmful pathway for multidrug-resistant organisms, or superbugs.

Essentially the most feared amongst them are carbapenemase-producing Enterobacterales (CPEs), reminiscent of E. coli strains that colonise the intestine harmlessly however may cause deadly infections in the event that they enter the bloodstream. CPEs are proof against virtually all antibiotics, with mortality charges from 30% to greater than 50%.

Based on the report, worldwide analysis has linked a good portion of hospital-acquired CPE instances to sinks. Research estimate 7–40% of affected person acquisitions originate from them. In French ICUs, half of sink drains have examined constructive for multidrug-resistant organisms. A German examine discovered ICUs with sinks had 30% larger charges of hospital-acquired infections, added the report.

Rise in superbug instances triggers drastic motion

Wexham Park started contemplating water-safe insurance policies after will increase in CPE instances: 8 detected in 2022–23, rising to 14 in 2023–24, with restricted screening. Whereas many instances represented innocent colonisation, as much as 20% can progress to an infection. That was sufficient for the belief to behave.

Now, all sufferers are screened on admission and discharge.

Early outcomes are placing as hospital-acquired CPE instances fell from 80 in 2024–25 to 40 in 2025–26. In ICU, charges of infections throughout the board — together with pneumonia— have dropped by virtually half. The Eden Day oncology unit reported only one new CPE case since early 2024, down from 9 the earlier yr, reported The Telegraph.

Tradition shock for employees

For nurses and docs, adjusting to water-free workflows has been a seismic cultural shift.

“Handwashing is what we’re taught — Florence Nightingale handwashing,” The Telegraph quoted ICU matron Ruramai Chidzambwa as saying. Senior sister Sandra Stirzaker admits she nonetheless finds herself strolling to the place sinks was.

As an alternative of sinks, ICU bays now function sanitiser stations, glove dispensers and specialised waste bins. Solely three sinks stay within the unit, together with two experimental wall-mounted faucets referred to as “Frimley taps”, which dispense a single litre of water at a time. Employees depend on wipes for affected person hygiene, gather restricted water for laundry, and use gel plus dental-style suction to scrub sufferers’ tooth.

“It’s fairly difficult to maintain strolling round,” stated employees nurse Margie Yambao, whose journeys to the distant faucet have turn out to be a part of her each day routine.

Regardless of the logistical hurdles, sanitiser — used between each affected person interplay —has changed cleaning soap and water for many employees. Palms are washed solely when visibly dirty, after bathroom use, or when caring for sufferers with gastrointestinal infections.

Why cleaning soap and water aren’t all the time safer

To infection-control specialists, the shift aligns with mounting proof that water can carry extra threat than profit in medical settings. Previous infection-control approaches pushed hospitals to put in sinks “in each nook,” particularly to fight infections reminiscent of C. difficile. However newer research present C. difficile can contaminate sinks as properly.

Preserving every sink “secure” prices about £1,000 per yr, in accordance with the belief—a big sum in an period of rising NHS monetary pressures.

At Wexham’s redesigned ICU utility room, new washable bowls and nine-minute disinfection cycles substitute a lot of the sink’s position. Even the bathe room has been re-engineered: the bathe head was moved removed from the plughole to stop splash-back.

Chidzambwa says the turning level was reframing the idea, “Defining it as hand hygiene made a distinction.”

Sufferers regulate to water-free hospital

Reactions amongst sufferers have ranged from shock to curiosity. Within the Eden Day oncology unit, chemotherapy sufferers sit beside bottles of hand sanitiser slightly than sinks.

“Particularly in a hospital surroundings, it was stunning,” The Telegraph quoted  Rosalind Bieber, accompanying her companion for therapy, as saying.

“However all over the place you go they’ve hand sanitiser—you’re not in need of it,” Bieber added.

Sisters Marian Poff, 71, and Eileen Conroy, 68, admit the change felt unusual.

Conroy, herself an oncology nurse at one other hospital, stated, “If I’ve a sandwich, I like to clean my palms… But when outcomes are proving constructive, go together with it.”

International motion towards water-free ICUs

The UK is just not pioneering this method alone.

At Radboud College Medical Heart within the Netherlands, microbiologist Dr Joost Hopman led a two-year examine eradicating sinks after outbreaks linked to Enterobacter cloacae.

“We tried cleansing and disinfecting, placing disinfectants within the drain—nothing labored,” An infection Management quoted Hopman as saying.

Biofilms, he explains, all the time return. “To me, the one sustainable resolution is to take away this supply,” Hopman added.

Faucet water itself is usually a threat, carrying micro organism like Pseudomonas and Legionella. Sinks additionally create aerosols that contaminate close by surfaces, together with medication-prep areas. Mixed with biofilm progress deep in plumbing, sinks turn out to be almost inconceivable to sanitise reliably.

Hopman emphasises that sink elimination is just one piece of an infection management.

“Prevention is all the time a multimodal intervention,” he stated. However eliminating a relentless supply of multidrug-resistant micro organism makes each different measure simpler.

The longer term: Waterless hospitals?

Dr Meda envisions even bolder improvements, together with aviation-style waterless bathrooms. “Wexham is a blueprint for the NHS,” she stated, although she acknowledges the cultural transition has been vital.

For Dr Alber, the preliminary sceptic, the proof has been persuasive. He admits he as soon as used operating water merely to heat his palms earlier than inspecting sufferers. Now he accepts that these sinks could have posed extra hazard than consolation.

“I very a lot help the venture,” he stated. “I believe it ought to be the usual.”

Then he smiles. “However I don’t assume handwashing is a foul factor both.”

With inputs from companies