- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive for what reason the MRSA Screening Pathfinder Programme Final Report Volume 1: An Investigation of the Clinical Effectiveness of Universal MRSA Screening was delivered in December 2009 but published in February 2011 and, if this was an error on the published document, what the actual date of delivery was.
Answer
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.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive what the likely (a) costs and (b) savings are in rolling out a Scotland-wide MRSA screening programme for hospital admissions.
Answer
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.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive for what reason NHS Scotland Wheelchair and Seating Services - Clinical Standards Consultation does not include a mobility plan for users or carers who are to be assessed for the optimum equipment.
Answer
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.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive what its position is on the risks of increased mupirocin consumption and resistance that might result from a Scotland-wide MRSA screening programme on admission to hospital and of staff.
Answer
Health Protection Scotland has advised that current monitoring by the Scottish MRSA Reference Laboratory indicates no significant increase in mupirocin resistance within the Pathfinder boards.
This will be continued to be monitored.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive whether the estimates of the NHS Quality Improvement Scotland health technology assessment economic model assumptions in the report on the MRSA Screening Pathfinder Programme have been or will be subject to peer review.
Answer
Health Protection Scotland has advised that the estimates for assumptions made within the NHS QIS Health Technology Assessment (HTA) model were peer reviewed and underwent public consultation according to NHS QIS process for the production of HTAs.
Many of the estimates made in the original modelling process have in fact been confirmed by subsequent data drawn from the Pathfinder Programme and the special studies.
The information subsequently used in the MRSA Screening Pathfinder version of the model was derived from the Pathfinder Study.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive for what reason NHS Scotland Wheelchair and Seating Services - Clinical Standards Consultation does not refer to the right to a second opinion arising from an appeal.
Answer
NHS Scotland Wheelchair and Seating Services are already fully compliant with NHS policy regarding the right to a second opinion.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive for what reason NHS Scotland Wheelchair and Seating Services - Clinical Standards Consultation does not refer to complaints procedures.
Answer
NHS Scotland Wheelchair and Seating Services are already fully compliant with NHS complaints procedures.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive whether the NHS Scotland Wheelchair and Seating Services - Clinical Standards Consultation will invite responses from those users, carers and voluntary sector representatives who were represented by the Wheelchair and Seating Services Project Board.
Answer
The draft clinical standards were released for a 12 week period of public consultation, which closed on 25 February 2011. All members of the Wheelchair and Seating Services Project Board were included in the distribution of consultation documents, which are also freely available on the Scottish Government website at:
http://www.scotland.gov.uk/Publications/2010/12/06095313/0.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive what the (a) risks and (b) benefits are of rolling out a Scotland-wide MRSA screening programme for hospital admissions.
Answer
Health Protection Scotland has advised that the principal anticipated benefit of the screening programme is a reduction in MRSA infections in acute hospitals. MRSA infection has a negative impact on quality of life and length of stay in hospital, therefore lowering of colonisation rates reduces the risk of infection in the patient population.
The use of clinical risk assessment also allows pre-emptive management of patients identified as being at higher risk of MRSA colonisation in anticipation of laboratory results being available, thereby reducing the risks of transmission to other patients.
Continuing study of the epidemiology of MRSA colonisation and infection will be required.
- Asked by: Dr Richard Simpson, MSP for Mid Scotland and Fife, Scottish Labour
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Date lodged: Monday, 28 February 2011
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Current Status:
Answered by Nicola Sturgeon on 11 March 2011
To ask the Scottish Executive what the confidence intervals are for the predicted reductions in MRSA colonisation prevalence and infection incidence associated with MRSA laboratory test-based screening.
Answer
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 |
