Chamber and committees

I refer the member to the answer to question S3W-16185 on 18 September 2008. 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/webapp/wa.search.

The Scottish Ambulance Service anticipate that the additional member of staff will be trained and in post before the end of this calendar year.

NHS Greater Glasgow and Clyde has advised that in addition to induction training as previously outlined, a training session dedicated to Clostridium difficile was provided for nursing staff at the Vale of Leven Hospital in May 2007.

Since May 2007, 73 staff from the hospital have also registered for cleanliness champion training.

Three two-hour sessions a day are also being held for the next two weeks at the hospital. This commenced on Monday 15 September 2008 with 48 staff (all staff groups) attending on the first day.

Other training to have taken place at the Vale of Leven Hospital includes a Clostridium difficile care bundle education session on 28 August 2008, infection control training for domestic staff on 27 August 2008, hand hygiene audit tool training on 5 September 2008, infection control for physiotherapists on 5 June 2008 and training on statistical process charts on 8 September 2008.

A critical issue in the surveillance of Clostridium difficile cases is in identifying when the number of cases in any one ward breaches an agreed control level in a defined period of time, which would indicate the need for an outbreak control team to be established. Until May 2008 and including the period between January to April 2008 when there was a peak in the new Clostridium difficile cases at the hospital, although daily monitoring of Clostridium difficile prevalence was in place, there was no agreed upper levels to alert local staff of an excess of new cases over a period.

Regular meetings take place between NHS Greater Glasgow and Clyde and Scottish Government Officials. The Chief Executive of NHS Greater Glasgow and Clyde will provide progress reports to the chief nursing officer on a monthly basis. Greater Glasgow and Clyde will also discuss progress at their monthly cycle of board meetings. A report will come monthly to either the Performance Review Group or NHS board.

The monthly reports will be published on the board''s website.

NHS Greater Glasgow and Clyde advise that the group is chaired by the chief executive and includes the board''s medical director, The board''s nurse director, the chief operating officer for the acute division, the head of nursing for acute services, the board''s infection control manager, the Clinical Director for the Public Health Protection Unit and the nurse consultant in infection control. This group is responsible for preparing and providing their progress reports referred to in the answer to question S3W-15692 on 17 September 2008. 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/webapp/wa.search.

The Scottish Ambulance Service baseline budget for 2007-08 was £177.794 million and for 2008-09 was £183.394 million. The increase represents a 3.15% uplift.

Budgets for forward years have not yet been set.

NHS Argyll and Clyde and NHS Greater Glasgow and Clyde were both visited during 2004-05 as part of the Healthcare Associated Infection (HAI) standards peer review programme. The Vale of Leven Hospital was part of NHS Argyll and Clyde Acute Hospitals Trust at this time.

NHS Quality Improvement Scotland (NHS QIS) standards are considered for revision and updating every three years. The most recent standards were published in March 2008, and future arrangements for performance assessment against the standards are in development. Further information is available on the NHS QIS website at:

http://www.nhshealthquality.org/nhsqis/controller?p_service=Content.showandp_applic=CCCandpContentID=4099.

The NHS QIS review process is just one of the ways in which we monitor NHS board performance against HAI Targets, and given the importance of hand hygiene compliance, I have requested that Health Protection Scotland (HPS) move from three to two monthly reporting on NHS boards compliance from January 2009. I have also increased the target of 90% compliance by November 2008 to 95% compliance by April 2009.

As noted in the independent review team report no routine monitoring was undertaken within the dates requested.

Guidance on Prudent Antimicrobial Prescribing: The Scottish Action Plan for Managing Antibiotic Resistance and Reducing Antibiotic Related Clostridium Difficile Associated Disease was issued under cover of CEL30(2008) on 8 July 2008. This guidance recommends that all NHS boards should immediately establish an antimicrobial management team (AMT) which should cover primary and secondary care prescribing activities. A key role for the AMT Board is the implementation and compliance monitoring of a local antimicrobial policy.