Chamber and committees

The Scottish Government is not involved in the process for considering applications to open new community pharmacies. I am not aware whether any NHS board has approached the Scottish Health Council in relation to any such application to open a community pharmacy in an area served by a dispensing GP practice.

I refer the member to the answer to question S3W-23328 on 11 May 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.

The decision to introduce a national MRSA screening programme was taken, to minimise the spread of infection in hospital, minimise the risk of infection between patients and to ensure public confidence. However, following the full evaluation of the Pathfinder pilots the national screening programme may be modified in light of any further evidence that may emerge.

Those patients who are previously known MRSA colonised are included in the national screening programme for screening of most elective admissions and the defined high-risk specialties. NHS boards MRSA policies are based on local clinical risk assessment and, in general, involve targeted screening of specific specialities and patient populations, including those with a previous history of MRSA. This will continue as part of the routine local clinical risk assessment on admission.

The key objectives for aim three on staff and patient acceptability are:

To explore patient and family experiences and opinions of the MRSA screening programme, identifying perceived benefits and aspects they feel could be improved upon, relative to their perception of risk of MRSA infection.

To determine staff awareness and understanding of the MRSA screening programme, identifying perceived benefits and aspects they feel could be improved upon.

To evaluate the effectiveness of the communications used to inform patients and staff of the MRSA Screening programme.

To explore the acceptability of MRSA screening from a wider population perspective beyond the Pathfinder Board areas.

A variety of approaches will be adopted (subject to ethical approval) to measure aim three, incorporating quantitative and qualitative data sources (measures), including:

a selective evidence synthesis of existing research related to patient and staff views of screening for infection

online survey of all clinical staff groups, using a combination of Likert scale questions with associated open response opportunities to enable expansion or explanation of their views

on-going thematic analysis of an on-line discussion board (specially designed as part of the evaluation project) for clinical staff to encourage anonymous posting of views and experiences

focus group discussions with a randomised sample of clinical staff at each Pathfinder board, stratified according to staff grouping, using the nominal group technique to prioritise concerns and generate recommendations for future screening

telephone interviews with recently discharged service users (patients and primary visitor) to generate topic areas of issues and concerns related to MRSA screening, which will be incorporated into a patient/visitor survey tool

postal survey of patients and their associated primary visitor, sub divided into two cohorts (those who were screened positive and those who were screened negative as consequence of MRSA screening)

postal survey of wider public perceptions beyond the Pathfinder Boards, using the electoral register to select a representative sample of the population in both urban and rural areas.

concluding interviews with Pathfinder Board project management teams to collate experiences, lessons learned and recommendations for future implementation.

Currently non-pathfinder NHS boards have local policies for MRSA screening as part of their local infection control policies. These policies are based on local clinical risk assessment related to MRSA and in general involve targeted screening of specific specialities and patient populations. For example, patients with a past history of MRSA, frequent re-admissions, admissions from care homes, patients admitted to intensive therapy units, cardiothoracics, orthopaedics and vascular surgery. These policies will be modified by NHS boards to include the requirements of the national MRSA screening programme.

There are known risk factors for colonisation with MRSA, for example, patients with a past history of MRSA, frequent re-admissions, direct interhospital transfers from hospitals abroad or hospitals in the UK with a high prevalence of MRSA and residents care facilities, such as care homes. NHS boards MRSA policies are based on local clinical risk assessment and, in general, involve targeted screening of specific specialities and patient populations, including residents of care homes. It is important to note that these patients represent a small proportion (1.6%) of all admissions to acute hospitals.

This approach is in line with UK guidance published in the Journal of Hospital Infection May 2006 (Guidelines for the Control and Prevention of Meticillin Resistant Staphylococcus aureus (MRSA) in Healthcare Facilities).

Those patients who are readmissions are included in the national screening programme for most elective admissions and high risk specialties. NHS boards MRSA policies are based on local clinical risk assessment and, in general, involve targeted screening of specific specialities and patient populations. This will continue as part of the routine local clinical risk assessment on admission.

I refer the member to the answer to question S3W-23328 on 11 May 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.

CEL 48 (2008) issued on 11 November 2008 provides guidance to NHS boards on the provision of 100% single room accommodation for new build facilities and a minimum of 50% for refurbished facilities. Patients with infection do not always need to be cared for individually in single rooms. It is acceptable to practice cohort care for multiple patients with the same infection within a circumscribed ward area.

The availability of isolation rooms is, however, being monitored throughout the duration of the MRSA Screening Programme Pathfinder Boards project.