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Health and Sport Committee 08 March 2016

08 Mar 2016 · S4 · Health and Sport Committee

Item of business

Subordinate Legislation

Healthcare Improvement Scotland (Delegation of Functions) Order 2016 (SSI 2016/86)

Watt, Maureen SNP Aberdeen South and North Kincardine Watch on SPTV

Thank you for providing me with the opportunity to explain the rationale behind the Healthcare Improvement Scotland (Delegation of Functions) Order 2016. Tackling and reducing healthcare associated infection and containing antimicrobial resistance remain a key priority for ministers and the Scottish Government. Latest figures show that, since 2007, cases of Clostridium difficile in patients who are aged 65 years or over have reduced by 84 per cent and cases of methicillin-resistant staphylococcus aureus—MRSA—have reduced by 88 per cent. Although that demonstrates significant progress, the challenge is to look at ways to continue the reduction in order to drive down HAI rates. The incidence of key HAIs has plateaued over the past two years. We need to work even harder to ensure that those figures move in the right direction as we strive to make appropriate and updated advice accessible to all who deal with infection prevention and control. The Government will continue to drive forward improvements across NHS Scotland as we work closely with Healthcare Improvement Scotland, Health Protection Scotland and the Scottish antimicrobial and healthcare associated infection strategy group to reduce infection rates further. We will also support health boards to deliver further improvements for the safety of healthcare staff, patients and the public. I turn to the specific measures that the order contains. The Scottish Government fully accepted all the recommendations that were made in the Vale of Leven hospital inquiry report. Recommendation 1 in Lord MacLean’s report was that the “Scottish Government should ensure that the Healthcare Environment Inspectorate (HEI) has the power to close a ward to new admissions if the HEI concludes that there is a real risk to the safety of patients. In the event of such closure, an urgent action plan should be devised with the Infection Prevention and Control Team and management.” The order implements that recommendation by giving HIS the powers to direct a board to close a hospital ward to new admissions when HIS considers that, without the direction to close, there would be a serious risk to life, health or wellbeing. The powers will not be limited to closure for reasons of cleanliness and will apply for other safety reasons, such as staffing levels and other non-medical reasons. The powers are designed to ensure patient safety and it is therefore right that they should cover all circumstances in which there is a serious risk to life, health or wellbeing. In conjunction with the Scottish Government and other interested stakeholders, HIS has developed an escalation procedure that includes arrangements on the powers to direct the closure of wards to new admissions. The draft procedure was shared with health boards on 3 March for their views and I have asked for a copy of the final paper to be sent to the committee for its information. I should stress that closing a ward to new admissions is intended to be an option of last resort and that we hope that it is never needed. I assure the committee that HIS will work with NHS boards—particularly chief executives and medical directors—to address any concerns that are raised as a result of an inspection of any hospital. My officials have confirmed that the escalation procedure will provide a clear, transparent and consistent process to manage the identification and escalation of serious issues that might be facing NHS service delivery, quality, safety of care and organisational effectiveness. The escalation process will ensure clear communication paths across all stakeholders, clarity over roles and responsibilities, and an explicit record of actions that have been undertaken in partnership with boards to secure a timely resolution. Consistent and effective communication between HIS and board officials will be crucial to achieving that resolution. The order meets our commitment to implementing recommendation 1 of the Vale of Leven hospital inquiry report. It gives HIS the power to direct NHS boards to close a hospital ward to new admissions when HIS considers that there is a serious risk to life, health or weIlbeing. The draft escalation process that HIS has published makes it clear that the power will be used only very rarely and as a measure of last resort. It is, however, an important additional tool to safeguard patient safety. I am happy to answer any questions that members have.

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Health and Sport Committee 08 March 2016

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