Chamber and committees

Information on the total number of patients who have contracted norovirus in NHS Lanarkshire is not available.

The number of laboratory confirmed cases of norovirus infection that are reported to Health Protection Scotland by NHS board is provided in the answer to question S4W-04429 on 20 December 2011. This information is not available at hospital level.

Health Protection Scotland monitors and publishes ward closures due to presumed or confirmed norovirus outbreaks via a point prevalence surveillance. Weekly point prevalence data by NHS board for 2008 to 2011 is available in the answer to question S4W-04427 on 20 December 2011. This provides an indicator (in as close to real-time as is possible) of the impact norovirus is having on NHSScotland.

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/parliamentarybusiness/28877.aspx.

Information on the total number of patients who have contracted norovirus is not available.

The number of laboratory confirmed cases of norovirus infection that are reported to Health Protection Scotland (HPS) are provided for each NHS board and calendar years 2007 to 2011 grouped into four-week periods. The tables are available from the Scottish Parliament Information Centre (Bib. number 53504).

These data are based on voluntary reporting by clinical laboratories in Scotland to HPS on a weekly basis and include cases originating in both healthcare and community settings.

Laboratory confirmed cases are only a subset of the absolute number of patients infected with norovirus. These figures will not include those infected with norovirus, who did not seek medical attention or have a stool sample submitted. Only a small proportion of cases are likely to seek medical advice and of those who do only a small sample will have a stool sample submitted. Therefore, the figures shown should be treated with caution.

Health Protection Scotland monitors and publishes ward closures due to presumed or confirmed norovirus outbreaks via a point prevalence surveillance. Weekly point prevalence data by NHS board for 2008 to 2011 is available in the answer to question S4W-04427 on 20 December 2011. This provides an indicator (in as close to real-time as is possible) of the impact norovirus is having on NHSScotland.

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/parliamentarybusiness/28877.aspx.

Health Protection Scotland monitors and publishes ward closures due to presumed or confirmed norovirus outbreaks via a point prevalence surveillance. This is Management Information data and not Official Statistics. Norovirus point prevalence reporting commenced on 7 January 2008.

This weekly point prevalence data relates to the number of wards closed at any time on a Monday. This provides an indicator (in as close to real-time as is possible) of the impact norovirus is having on NHSScotland but is not incidence data and can therefore miss some outbreaks, i.e. if an outbreak started on a Tuesday and was over by the Sunday it would not be recorded on the prevalence data.

Ward closures occurring on a Monday that are still ongoing the following Monday will be counted twice even though they relate to a single outbreak.

Since this is point prevalence data it is not possible to aggregate this to get an annual total of ward closures. Weekly point prevalence data by NHS board for 2008 to 2011 is available from the Scottish Parliament Information Centre (Bib. number 53503).

Future weekly data for 2011 will be available at:

http://www.hps.scot.nhs.uk/haiic/ic/noroviruspointprev.aspx.

The relevant details are in the following table.

Nhs Lanarkshire: Hospital Ward Closures/Partial Ward Closures: 2007–2010

Source: NHS Lanarkshire

On 7 October 2011, the Scottish Government wrote to all NHS boards in connection with “Preparing for Winter 2010-11”. The purpose of the letter was to ensure that NHS boards were fully prepared for winter in order to minimise any potential disruption to NHS services, patients and carers. Norovirus preparedness was a key element of this. In addition, two winter planning seminars and a “lessons learned” session were held, highlighting best practice from previous years’ winter preparedness, including the handling of norovirus.

In addition, the Health Protection document Norovirus Outbreak Preparedness, Control Measures & Practical Considerations for Optimal Patient Safety and Service Continuation in Hospitals was revised and reissued on 30 September 2011 and provides a wide range of guidance to help prevent outbreaks of norovirus.

http://www.documents.hps.scot.nhs.uk/hai/infection-control/toolkits/norovirus-control-measures-2011-09.pdf.

The Health Protection Scotland document Norovirus Outbreak Preparedness, Control Measures & Practical Considerations for Optimal Patient Safety and Service Continuation in Hospitals was first issued in 2007 and revised and reissued on 30 September 2011. Section 4. The Norovirus Year – focussing on preparedness in particular advised boards on activity required to help prevent norovirus outbreaks.

http://www.documents.hps.scot.nhs.uk/hai/infection-control/toolkits/norovirus-control-measures-2011-09.pdf.

The Healthcare Associated Infection (HAI) National Advisory Group was established in May 2011 and meets quarterly. As part of its remit, it has a role in advising the Scottish Government on the use of new technologies for the prevention of healthcare associated infections. In addition, the HAI Commodities Advisory Group, hosted by NHS National Procurement, meets three times a year to consider whether any new technologies should be adopted at a national level. In the past year neither group has submitted a formal recommendation to the HAI National Policy Group for any new technology which should be adopted.

Furthermore, the Hospital Outbreak Advisory Group (HOAG) advises the National Advisory Group on all matters related to hospital outbreaks. Health Protection Scotland (HPS) has a role in continuously reviewing the literature on new publications on the application of novel technologies and novel approaches to reduce the likelihood and impact of norovirus outbreaks in hospitals.

The chief nursing officer wrote to all boards on 14 December 2009 informing them on the procedures for reporting outbreaks of norovirus. This guidance is still extant and in use.

Healthcare Associated Infection (HAI) - Reporting of Incidents and Outbreaks and Norovirus Guidance

http://www.show.scot.nhs.uk/sehd/publications/DC20091214HAIreporting.pdf.

Symptoms from Norovirus usually last for 24 to 48 hours. In line with infection control guidance, staff are required to be symptom free for more than 48 hours before returning to work.

NHS Lanarkshire have confirmed that they are covering any staffing shortfalls as a result of the recent outbreak through the use of the local nurse bank, overtime, and additional hours; alongside a small reduction in planned activity - the staff from which are redeployed as appropriate in line with infection control guidance. The NHS board has provided assurances that they are ensuring that safe minimum staffing levels are being maintained based on the clinical assessment of patient condition and numbers, and general workload.

NHS Lanarkshire are responsible for the provision of high quality, safe and sustainable local healthcare provision in line with national policy and guidelines.

The health board has confirmed that it ensures each local hospital site has an annual Norovirus Preparedness Plan which includes a range of actions to be taken starting in September of each year with frontline staff (both day and night shift) bed managers and senior management. These actions include a range of educational sessions and infection control nurse attendance at daily bed meetings, which are also attended by bed managers, senior nurses and the senior charge nurse/team leader or deputy from each ward.

NHS Lanarkshire have confirmed this process ensures that any patients and/or staff considered to be suspected of having Norovirus are identified early with optimum patient placement and staff exclusion being considered to minimise risks of cross infection to others. Senior charge nurses/team leaders also are responsible for the daily completion of a Norovirus aide memoire which is a nationally developed tool to ensure that precautions are adhered to within affected areas.

NHS Lanarkshire has also developed a Norovirus escalation plan, based on a national model, for use when Norovirus is considered to be spreading within a hospital setting. The board has produced a patient and visitor Norovirus information leaflet which is available in all wards to raise awareness if the prevention and control of infection and visiting to areas is restricted. In addition, staff working in affected wards are not permitted to work in non-affected areas to further minimise the spread.

All NHS boards, including NHS Lanarkshire, also maintain regular contact with Health Protection Scotland to ensure that all measures aimed at containing the spread of infection have been taken.