Summary
The Cabinet Secretary for Health and Wellbeing commissioned an independent review of procedures in place at the Vale of Leven Hospital over the period December 2007 to 1 June 2008 in response to information that 55 patients had developed Clostridium difficile associated disease ( CDAD), 18 of whom had died.
The report produced by the Independent Review Team made eight recommendations to be implemented as a matter of urgency for the hospital. The final recommendation was that an audit of implementation of these recommendations be conducted by the end of 2008, with patient representatives included in the audit process.
The Review Team had access to documentary evidence of progress in implementing the recommendations. The Review Team, with patient representatives, attended presentations at the hospital, conducted a walk round of various wards, and the Review Team and one patient representative interviewed the Chief Executive and senior managers of NHS Greater Glasgow and Clyde. Individual team members made further enquiries in a number of specific areas.
The Review Team found that the recommendations had been systematically addressed by NHS Greater Glasgow and Clyde and monitored through monthly progress reports. Infection policies had been revised as recommended and a major training exercise for all staff had been completed. Antimicrobial policy had been implemented and decreases in antibiotic use have been demonstrated through monitoring and feedback by a dedicated antimicrobial pharmacist who visits for one day each week.
A much improved and more direct organisation for the control of infection is being implemented and will be fully integrated with the rest of the NHS Greater Glasgow and Clyde area by March 2009. This is being supported by a number of key appointments to be made in February and March 2009.
All Senior Charge Nurses are now participating in a national development programme and clinical quality indicators have been adopted for each ward area. Communication about infection control among staff, patients and relatives has been strengthened, and very significant improvements have been made to the physical environment of the hospital, with the refurbishment scheduled to be completed, as planned, in May 2009.
There is documented evidence that rapid and very significant progress has been made in implementing the recommendations of the Review Team at Vale of Leven Hospital. The Review Team has been impressed by the positive changes to the physical environment and positive atmosphere of the hospital.
While much of the work has been completed, some will be undertaken over the next few months and monitoring of progress must continue. There are two areas in which the implementation of recommendations is dependent on national guidance. First, implementation of the NHS Dress Code Guidance and second, clarification of the guidance on the medical certification of the cause of death related to healthcare associated infections ( HAIs).
Building sustainability in each of the seven areas covered by the recommendations is crucial to maintaining the achievements. The long-term commitment of NHS Greater Glasgow and Clyde Board to delivery of health care at the Vale of Leven Hospital will contribute to the sustainability of achievements made thus far.