Questions and answers

Question reference: S3W-14231

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive what procedures were followed by NHS Greater Glasgow and Clyde in relation to the outbreak of clostridium difficile in the Vale of Leven Hospital and when

Question reference: S3W-14227

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive whether it will establish an independent inquiry into the outbreak of clostridium difficile in the Vale of Leven Hospital, with the report of the inquiry being made public.

Question reference: S3W-14229

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive whether it is concerned about the percentage mortality rate in relation to the outbreak of clostridium difficile in the Vale of Leven Hospital.

Question reference: S3W-14232

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive whether any of the incidences of clostridium difficile in the Vale of Leven Hospital occurred in patients transferred from other hospitals and, if so, how many patients were involved and from which hospitals.

I am advised that seven of the 55 patients confirmed as having clostridium difficile were originally transferred from the Royal Alexandra Hospital, between 28 December 2007 and 25 March 2008, to the Vale of Leven Hospital. It cannot be confirmed, however, if these patients contracted clostridium difficile before being admitted or whether they contracted the infection after arrival at the Vale of Leven Hospital.

Question reference: S3W-14226

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive whether it is satisfied that all cases of clostridium difficile in the Vale of Leven Hospital from December 2007 to June 2008 have now been identified.

Question reference: S3W-14223

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive what the procedure is for dealing with the outbreak of infection in hospitals.

The management of outbreaks in hospitals is set out in Annex 4 of the 2003 interim guidance document Managing Incidents Presenting Actual or Potential Risks to the Public Health: Guidance on the Roles and Responsibilities of Incident Control Teams, which may be accessed at:

http://www.scotland.gov.uk/Publications/2003/01/16243/17308.

This document is currently under review and an updated version of Annex 4 will be issued shortly.

Question reference: S3W-14228

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive what incidences of clostridium difficile there have been in each hospital in NHS Greater Glasgow and Clyde, broken down by (a) numbers infected and (b) subsequent fatalities caused in whole or part by clostridium difficile in the Vale of Leven Hospital in each month in (i) 2007 and (ii) 2008.

Information on the number of clostridium difficile cases is currently reported quarterly by Health Protection Scotland and broken down by NHS board. Scottish Government officials have, however, written to all NHS boards, including NHS Greater Glasgow and Clyde, to ask them to provide a report on the number of clostridium difficile cases for each acute hospital within their area, providing data at hospital level, for the period December 2007 to May 2008.

We have asked that the information includes all cases diagnosed from admission onwards and for a commentary on interpretation of the data presented, whether any clusters were identified, and what actions were taken in response to any apparent excess of cases or deaths over this period.

Question reference: S3W-14225

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive why there was a delay in reviewing cases of clostridium difficile during the outbreak in the Vale of Leven Hospital.

Question reference: S3W-14224

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive what steps should be taken and in what timescale for (a) notifying and (b) controlling the outbreak of infection in hospitals.

Question reference: S3W-14230

Asked by: Jackie Baillie, MSP for Dumbarton, Scottish Labour
Date lodged: Friday, 13 June 2008
Current Status: Answered by Nicola Sturgeon on 27 June 2008

To ask the Scottish Executive what measures are being put in place to tackle clostridium difficile in hospitals.

The principal interventions effective against clostridium difficile (C.diff) in our hospitals are rapid diagnosis and isolation of patients; prudent prescribing of antibiotics; environmental cleaning; and rigorous hand hygiene procedures.

Mandatory national reporting of C.diff cases by laboratories was established in 2006, and the national C.diff reference laboratory for Scotland was established in 2008, which is a source of expert advice as well as providing information on typing of strains such as the hyper-virulent O27 strain. A national policy on provision of single rooms in new hospitals is also under development.

Prudent prescribing guidance was issued to NHS boards in 2005 by the HAI Task Force, and this was followed up by the launch in March 2008 of the Scottish Management of Antimicrobial Resistance Action Plan. The action plan has already resulted in the funding and establishment of the Scottish Antimicrobial Prescribing Group, which will oversee national surveillance of resistance and antibiotic use, and drive improvements in prescribing practice.

The Scottish Government’s HAI Task Force issued the national cleaning services specification in 2004, and the related monitoring system has shown continuing improvements in hospital cleaning standards across Scotland ever since. Monitoring of compliance with hand hygiene has also shown good improvements, with all NHS boards making good progress towards achieving our target of 90% hand hygiene compliance by staff by November 2008. This is supported by our ongoing national hand hygiene campaign.

Health Protection Scotland have also issued a model policy document on transmission based precautions, advice on management of C.diff O27, and a “care bundle” of five essential elements of care for all C.diff patients. An overarching new Scottish guidance document on C.diff is currently under preparation by HPS.

The independent review of Vale of Leven cases announced by me on 18 June 2008 will examine any failings there may have been in following these procedures.

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