Marlyn Glen MSP

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Scottish Labour MSP for North East Scotland

Ninewells C difficile outbreak : MSP seeks Scottish Government financial support assurance

11 November 2009

Marlyn Glen has written to NHS Tayside asking how its resources as a health board and those at Ninewells compare with those set out in the 15-point plan put forward by the leading microbiologist , Professor Hugh Pennington, to combat C difficile and other hospital bugs..

Ms. Glen said that she wants an assurance from Health Secretary Nicola Sturgeon that “NHS Tayside and Ninewells will receive the resources that they need to control the spread of C difficile and other hospital acquired infections.” based upon the “full implementation” of the recommendations of Professor Pennington’s plan.

Ms. Glen said,

“This comprehensive plan details the strategic approach to be taken in the drive against healthcare associated infections effectively and to reduce the incidence of C difficile cases by 50 per cent by March 2011.

” Its full implementation would set rigorous standards in infection prevention and control that would mean cleaner and safer wards.”

The plan’s recommendations include :

*crash programmes for the provision of isolation facilities for all C Diff/MRSA patients. and for quality hand-washing facilities in all wards.

*The number of staff in key positions such as medical, scientific and cleaning staff to meet national standards

*Funding to ensure that cover is provided for staff shortages

*Target to reduce the rate of C difficile by 50% by March 2011.

The 15 point plan :
1. A robust monitoring system for the implementation of guidance at a board and hospital level is required. This should be subject to rigorous checks by inspection teams, independent of government, undertaking unannounced visits and not relying on a system of self-assessment.
2. An HAI Commissioner – to develop best practice and to co-ordinate and bring a sharper focus to the institutional clutter of those agencies responsible for tackling HAIs.
3. Crash programme to provide isolation facilities for all C Diff/MRSA patients. This is the provision of en-suite
single rooms in sufficient number to end sharing. The Scottish Government need to outline the timescale and resources for this to be achieved across the NHS.
4. Crash programme to provide quality hand-washing facilities (specifically temperature – controlled, sensor – operated, flow regulated taps) appropriately positioned in all wards.
5. Real time detailed analyses at ward level, (with high resolution fingerprinting of the causative microbes) is essential in tracking the spread of infection and for outbreak identification and control.
6. Monthly reporting, on a hospital by hospital basis, must be published and available centrally online for every hospital. Quarterly reporting by HPS of Scotland wide statistics would continue.
7. Budget to ensure that staffing numbers in key posts – control of infection nurse, scientist/microbiologist and cleaning staff posts meet national guidelines. Antimicrobial pharmacists should be deployed in every hospital and a central contingency fund should be established to ensure cover for any staff shortages.
8. Urgent need for workforce planning. It is understood that there are currently no medically qualified academic bacteriologists to train future specialists or conduct research.
9. Target to reduce the rate of clostridium difficile by 50% by March 2011.
10. Funding for the provision of surplus capacity of storage and washing facilities for soiled bedding and clothes at all hospitals in the event of an outbreak of C.diff.
11. Introduce sterile hygiene system for staff uniforms.
12. Facilities for steam cleaning of beds, curtains etc to be available in every hospital.
13. Budget for future increases in the levels of MRSA screening activity and the need for rapid turn-round times for tests with benefits both to the patients and to rapid infection control.
14. Funding for the Reference Laboratory should be increased to permit all isolates to be fingerprinted, and to develop typing systems which will identify new and potentially more virulent strains of C.diff.
15. A properly resourced reference laboratory should be established for Norovirus gastroenteritis, given its link to CDAD, in line with the MRSA and C.Difficile reference laboratories

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