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Vale of Leven C. diff probe: Long-awaited report due out Vale of Leven C. diff probe: Long-awaited report due out
(about 6 hours later)
A five-year inquiry into Scotland's worst outbreak of Clostridium difficile (C. diff) will be published later.A five-year inquiry into Scotland's worst outbreak of Clostridium difficile (C. diff) will be published later.
The probe, led by Lord MacLean, looked at the treatment of 63 patients at Vale of Leven Hospital in Dunbartonshire between December 2007 and June 2008.The probe, led by Lord MacLean, looked at the treatment of 63 patients at Vale of Leven Hospital in Dunbartonshire between December 2007 and June 2008.
Of the 31 patients who died, C. diff was a contributory factor in 28 cases.Of the 31 patients who died, C. diff was a contributory factor in 28 cases.
The independent inquiry was ordered in 2009 and completed at a cost of about £10m. Publication of the report had previously been delayed five times.The independent inquiry was ordered in 2009 and completed at a cost of about £10m. Publication of the report had previously been delayed five times.
C. diff is a bacteria which lives harmlessly in the gut of 10% to 15% of adults but causes diarrhoea when the delicate balance of gut flora is disturbed, often following a course of antibiotics. It is easily spread via airborne spores.C. diff is a bacteria which lives harmlessly in the gut of 10% to 15% of adults but causes diarrhoea when the delicate balance of gut flora is disturbed, often following a course of antibiotics. It is easily spread via airborne spores.
'Seismic impact''Seismic impact'
NHS Greater Glasgow and Clyde (GGC) said many changes had been made in the past six years, including £14m of investment at the Vale of Leven.NHS Greater Glasgow and Clyde (GGC) said many changes had been made in the past six years, including £14m of investment at the Vale of Leven.
"The Vale of Leven had a seismic impact on the way we deal with infection," said medical director Dr Jennifer Armstrong."The Vale of Leven had a seismic impact on the way we deal with infection," said medical director Dr Jennifer Armstrong.
"We have really transformed the monitoring. We have implemented the Scottish Patient Safety programme. We have put so many changes in place, and our C. diff rates are so low now, that we are very confident that these changes will prevent an outbreak.""We have really transformed the monitoring. We have implemented the Scottish Patient Safety programme. We have put so many changes in place, and our C. diff rates are so low now, that we are very confident that these changes will prevent an outbreak."
By far the biggest impact was made by changes to prescribing.By far the biggest impact was made by changes to prescribing.
Doctors were told to stop prescribing powerful general antibiotics and instead use targeted antibiotics which are less likely to upset the delicate balance of bacteria in the gut.Doctors were told to stop prescribing powerful general antibiotics and instead use targeted antibiotics which are less likely to upset the delicate balance of bacteria in the gut.
This led to an almost immediate 80% fall in C. diff cases.This led to an almost immediate 80% fall in C. diff cases.
Meanwhile all Scottish hospitals are now inspected to make sure they have adequate hygiene and infection control procedures.Meanwhile all Scottish hospitals are now inspected to make sure they have adequate hygiene and infection control procedures.
Cases of C.diff have fallen by 75% in Scotland, along with dramatic reductions in other hospital acquired infections.Cases of C.diff have fallen by 75% in Scotland, along with dramatic reductions in other hospital acquired infections.
'Question of attitude' Previous investigations into the outbreak by Health Protection Scotland and public health expert Prof Cairns Smith found the Vale of Leven Hospital had crowded wards, too few washbasins and poorly trained staff. Management practices were also severely criticised.
However, the son of an elderly woman recently treated at the hospital said attitudes there still needed to change.
The man (Mr C), who wants to remain anonymous, had his complaint about poor care at the Vale of Leven upheld by the Scottish Public Services Ombudsman last week.
"I felt my mother's care left a lot to be desired," said Mr C, whose mother died after a lack of adequate nutrition at the hospital.
"It's a question of attitude, and that attitude problem extended to the complaints procedure. When l tried to complain there were no leaflets or posters on the wall.
"I wrote a letter addressed to 'Whom it may concern' and left it with reception. It was like sending a letter to Santa Claus!"
Previous investigations into the outbreak by Health Protection Scotland and public health expert Professor Cairns Smith found the Vale of Leven Hospital had crowded wards, too few washbasins and poorly trained staff. Management practices were also severely criticised.
The inquiry is due to publish its findings at lunchtime on Monday.The inquiry is due to publish its findings at lunchtime on Monday.