Chamber and committees

The Healthcare Environment Inspectorate is currently reporting on the performance of each acute hospital in Scotland against the Standards for Healthcare Associated Infection (HAI) published by NHS Quality Improvement Scotland in March 2008. The reports are highlighting areas of good practice and areas which require improvement. There will be an annual report published by the chief inspector, which will point to local and national learning for HAI across the NHS in Scotland.

It is too early for the Inspectorate to highlight national learning and this will not be possible until every NHS board in Scotland has had at least one inspection and this is scheduled to be completed by the end of September 2010. All NHS boards have been required to have regard to the findings of each of the reports published by the Healthcare Environment Inspectorate in order that any necessary improvements can be made without delay.

In the event of an incident or outbreak, all NHS boards are required to complete an incident and outbreak reporting template. This is used to inform key contacts at both the Scottish Government and Health Protection Scotland. I have asked the HAI Task Force at its next meeting on 8 December to review the arrangements in place for notifying the public of incidents/outbreaks. I have also asked that any changes support a consistency of approach across the NHS; are based on the principle of a single point of contact between the Scottish Government and the NHS board and preserve the absolute priority of protecting the interests of patients and their families at all times.

The Scottish Antimicrobial Prescribing Group, established under the Scottish Management of Antimicrobial Resistance Action Plan, has set up a public campaign sub-group to review existing publicity materials and guidance. Following this work, consideration will be given to the need for a national campaign.

(a) Two-view mammography has been implemented in NHS Fife, NHS Greater Glasgow and Clyde, NHS Highland, NHS Orkney, NHS Shetland, NHS Tayside and NHS Western Isles.

(b) Two-view mammography has not yet been implemented in NHS Ayrshire and Arran, NHS Borders, NHS Dumfries and Galloway, NHS Forth Valley, NHS Grampian, NHS Lanarkshire and NHS Lothian.

All NHS breast screening centres are indicating that two-view mammography breast screening will be implemented by April 2010.

I refer the member to the answer to question S3W-29331 on 3 December 2009. 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.

We are working closely with all NHS breast screening centres and they are indicating that two-view mammography breast screening will be implemented by April 2010.

It is important that all staff, patients and visitors not only wash their hands with soap and warm water but combine this practice with the use of alcohol-based hand gels. This approach ensures that staff, patients and visitors are taking every precaution possible to reduce the risk of the spread of all avoidable infections. Hand gels are also available at hospital bedsides as a quick and effective way to protect patients and staff in between hand washing routines.

We recognise that tackling healthcare associated infection (HAI) is everyone''s business - staff, visitors and patients - and all have a part to play in driving down infection rates in hospitals. That is why a public awareness raising campaign involving TV and radio adverts ran earlier this year to educate the public on the importance of hand hygiene in reducing the spread of infections. I also launched a further awareness raising campaign aimed at NHS staff, consisting of posters and other supporting materials, in March this year. This is being widened out next year to include the community setting.

The Clostridium difficile organism is naturally present in the gut of a large percentage of children. However, it is rare for this to develop into an infection in this age group, and thus the numbers of patients aged 14 and under who become ill from Clostridium difficile are very low.

Testing methods and diagnosis of Clostridium difficile Infection (CDI) in children can also be unreliable and it is therefore not appropriate to carry out routine national mandatory surveillance for this age group.

There are no plans at present to widen the age range below 15 years of age. Health Protection Scotland do, however, continually review the surveillance programme and will extend it should this becomes appropriate.

Health Facilities Scotland established a working group to undertake a review if the Health Associated Infection System for Controlling Risk in the Built Environment (HAI-SCRIBE).

This review led to the development of an Estates Monitoring Tool to monitor the estate and to help support the drive to reduce HAI across the NHS. The tool will be piloted by all NHS boards between January and March 2010 prior to national implementation from April 2010. This tool will cover all of the estate, including those facilities which require minor to major refurbishment.

The national reference laboratory advise that although this ribotype exists in Scotland, there have not been any particular concerns raised about its transmissibility or lethality above those seen with other strains of Clostridium difficile.

Their expert advice is that all Clostridium difficile infections should be managed in accordance with the revised Health Protection Scotland Guidance on Prevention and Control of Clostridium difficile Infection (CDI) which was published in September 2009.