Chamber and committees

The Scottish Medicines Consortium is independent of Scottish Government.

Responses to the consultation A new value-based approach to the pricing of branded medicines are requested by 17 March 2011. Responses will be submitted directly to the Department of Health.

Health Protection Scotland advises that the report indicates that the revised Scotland-wide MRSA screening programme will be cost effective, with the cost per quality adjusted life year saved being modest in comparison with many other accepted healthcare interventions.

Model projections indicate costs for the clinical risk assessment screening approach plus swab-based screening of high impact specialties are half that of universal nasal swab-based screening, which was estimated to be £15 million in the health technology assessment.

In terms of rollout we anticipate the cost to be in the range between £2.8 and £4.9 million in NHS Scotland.

The report of the outcome of the MRSA screening study was delivered in December 2009. However, additional studies were being undertaken to consider the efficacy of nasal swabbing as a screening tool; and transmission through admission and discharge screening. The findings of these were used to inform policy direction. The related special studies reports were delivered in October 2010; and the National MRSA Programme Board advised that further work was required to interrogate and test the robustness of the special studies data.

It was important to consider all available evidence, including the recommendations of both the MRSA Programme Board and the HAI Taskforce, before any policy decision on the future direction of universal screening was taken, hence the delay between delivery and publication of this report.

Draft Standard 1, Essential Criteria 1.8 states that wheelchair need is recorded within the mobility section of the Single Shared Assessment when this assessment is used.

Responsibility for individual mobility plans, which include wider aspects of social care alongside wheelchair provision, does not rest solely with NHS wheelchair services.

Confidence intervals around the infection estimates are detailed for tertiary referral hospitals in the economic analyses report on page 14 in table 8-1; and for large general hospitals in the economic analyses report on page 15 in table 8-2 at:

http://www.documents.hps.scot.nhs.uk/hai/mrsa-screening/pathfinder-programme/mrsa-pathfinder-economic-2011-02-23

Health Protection Scotland (HPS) has provided the following information:

Number of Infections Five Years after Implementation of Strategy Showing Confidence Intervals for Each Estimate:

Hospital Type	Strategy	Cases Predicted in Year Five	Confidence Interval
Tertiary Referral	Do Nothing	512	426, 592
	Universal Nasal Screen	282	191, 366
	Clinical Risk Assessment (CRA)	322	235, 366
	CRA plus High Impact Specialties	303	211, 392
Large General	Do Nothing	111	88,134
	Universal Nasal Screen	71	47, 94
	CRA	85	62, 94
	CRA plus High Impact Specialties	78	55, 102

 

The main parameters which differed in practice from the assumed parameters within the HTA model were:

the proportion of patients attending pre-admission clinics within each age group;

the percentage of patients going to high and low risk specialty wards;

hospital prevalence at the start of the model; and

infection rate and length of stay.

The MRSA programme board evaluated and debated the findings and made a recommendation to the HAI Task Force on future direction for MRSA screening in NHSScotland.

The HAI Task Force then further evaluated the findings of the Pathfinder Programme and debated the recommendation from the programme board before endorsing its recommendations for future policy.

Yes, the reports on the Pathfinder Programme were subject to peer review by the appropriate working group; the MRSA Programme Board; and external experts.

Each report was reviewed according to HPS Quality Assurance protocol.

Health Protection Scotland has advised the health technology assessment model projected a reduction within five years of implementing screening to a level of very low endemic prevalence (<1%).

Continued monitoring of MRSA prevalence will be required as part of the assessment of the national screening programme''s performance in practice.

I refer the member to the answer to question S3W-39995 on 11 March 2011. All answers to written parliamentary questions are available on the Parliament''s website, the search facility for which can be found at:

http://www.scottish.parliament.uk/Apps2/Business/PQA/Default.aspx.