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The following tables show the annual figures for the number of discharges from acute hospitals in Scotland with a diagnosis of alcohol poisoning for the years 1981-82 to 2006-07.

World Health Organization International Classification of Diseases (ICD) codes have been revised four times from 1950 to date. ICD6 was in use from 1950 to 1957, ICD7 from 1958 to 1968, ICD8 from 1968 to 1980, ICD9 from 1981 to 1996 and ICD10 from 1996 to date. Codes cannot be matched exactly between revisions and as a result trend data is not reliable. The match between ICD9 and ICD10 however, is good and information has been supplied for the years covered by these two revisions.

ICD9 Codes

Year	Number of Discharges
1981-82	1,060
1982-83	892
1983-84	938
1984-85	1,046
1985-86	1,040
1986-87	1,101
1987-88	1,061
1988-89	959
1989-90	935
1990-91	1,019
1991-92	1,053
1992-93	1,169
1993-94	1,305
1994-95	1,342
1995-96	1,629

 

ICD10 codes

Year	Number of Discharges
1996-97	2,299
1997-98	3,315
1998-99	2,952
1999-2000	2,974
2000-01	3,016
2001-02	3,105
2002-03	3,130
2003-04	2,776
2004-05	2,896
2005-06	3,847
2006-07	3,929

 

I refer the member to the answer to question S3W-14693 on 21 July 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.

Whilst there are no plans to hold specific separate discussions with the Welsh Assembly Government, it is likely that there will be further discussion at UK level on how the findings of the Welsh review impact on the overall UK agreement and I can confirm the Scottish Government will participate in any such discussions and take any steps that are required to ensure Agenda for Change in Scotland is fit for purpose.

Agenda for Change is a UK-wide agreement and, as such, implementation issues throughout the UK are similar. However, in Wales, concerns were raised with the implementation process being used, particularly around the consistency of application and outcomes. The Welsh review rightly aimed to address a number of these concerns. In Scotland, Agenda for Change has been implemented in full partnership and arrangements have been in place to check consistency of outcomes prior to assimilation since the process began.

Representations in relation to “leapfrogging” have been made by health trades unions at both UK level, in the NHS Staff Council and at Scottish level in the Scottish Pay Reference and Implementation Group. There are no plans, however, to amend the assimilation process currently in place and which is being taken forward in partnership.

The information requested is not held centrally.

Monitoring infection rates at local level, for example by ward, clinical specialty or hospital, is the responsibility of each NHS board.

The independent review of the Vale of Leven hospital will examine the adequacy of local systems and practices that were in place there. The recommendations to be made by the review team may have implications for local systems and practices that operate elsewhere.

A range of national mandatory healthcare associated infection surveillance systems are in place to assist NHS boards in this exercise and all NHS boards are required to follow the NHS Quality Improvement Scotland Healthcare Associated Infection standards and the NHS Scotland Code of Practice. Cases of outbreaks of infections are reported to Health Protection Scotland who provide expert support, advice and guidance.

The cause of the outbreak in October 2007 could not be determined. The Outbreak Control team is currently reviewing the circumstances of the most recent outbreak at the Victoria Infirmary and a full report will be compiled. Six patients were affected in October 2007 and I understand that a further five patients were affected in the most recent outbreak, one of whom died on 24 June 2008. We are advised by NHS Greater Glasgow and Clyde that clostridium difficile was a contributory factor in the patient''s death.

The following is the original answer (published on 8 July 2008); see below

The cause of the outbreak in October 2007 could not be determined. The Outbreak Control team is currently reviewing the circumstances of the most recent outbreak at the Victoria Infirmary and a full report will be compiled. Six patients were affected in October 2007 and I understand that a further six patients were affected in the most recent outbreak, one of whom died on 24 June 2008. We are advised by NHS Greater Glasgow and Clyde that clostridium difficile was a contributory factor in the patient''s death.

It would not be appropriate for me to comment until the independent review announced by me on 18 June 2008 has examined all the circumstances surrounding the clostridium difficile cases at the Vale of Leven Hospital. The review team’s report is due to be published by the end of July 2008.

The clostridium difficile outbreak in October 2007 was managed by the local Outbreak Control Team who isolated the six patients affected in a temporary cohort isolation facility. In dealing with this outbreak, the board followed the procedures set out in Annex 4 of the 2003 guidance document Managing Incidents Presenting Actual or Potential Risks to the Public Health: Guidance on the Roles and Responsibilities of Incident Control Teams, which can be accessed at:

http://www.scotland.gov.uk/Publications/2003/01/16243/17308.

As a consequence of this outbreak, I am advised that NHS Greater Glasgow and Clyde put a range of actions in place and ordered a deep clean of affected ward areas, implemented its rapid response team and put additional resources into surveillance. More generally, all NHS boards must comply at all times with the national cleaning standards, the hand hygiene monitoring, the prudent prescribing of antibiotics procedures, appropriate infection control precautions (e.g. isolation) and rapid accurate diagnosis procedures.