By HELEN PUTTICK
8th August 2008
The Herald
The hospital bug Clostridium Difficile caused or contributed to nearly 300 deaths in Scotland in six months, an unprecedented investigation revealed yesterday.
The devastating toll the infection is taking on Scottish hospital wards was revealed at the same time as a highly critical report into a deadly outbreak of the bug the Vale of Leven Hospital in Dunbartonshire was published.
Charges could now be considered against health board NHS Greater Glasgow and Clyde, as the review of practices at the Vale has been passed to the area procurator-fiscal to consider if further action should be taken.
Between December last year and June 2008, 55 patients were diagnosed with C Diff infections at the Vale. Nine of these died as a direct result of the bug and it was a factor in a further nine deaths.
Tom Divers, chief executive of NHS GGC, yesterday apologised to the families affected by the outbreak. However, the board has said his resignation, or that of any other senior official, would not address the issues raised by the report into what happened.
The review team, commissioned by Scottish Health Secretary Nicola Sturgeon, described facilities at the hospital as "inadequate", including the space between beds, the availability of single rooms with toilets and the provision of sinks for hand-washing.
They noted an audit in February found dusty and dirty surfaces and raised concern about the way levels of the bug were monitored and the lack of leadership and supervision on infection matters.
Ms Sturgeon said the report made "disturbing reading".
She added: "The picture painted by the independent report of the facilities and procedures at the Vale of Leven is appalling and unacceptable and there should be no doubt NHS GG&C owes the patients and the families concerned an unconditional apology."
In response to the call of some of the families involved for a public inquiry, she passed the document to the Lord Advocate who in turn asked the procurator-fiscal to look into this.
Surveillance agency Health Protection Scotland has examined levels of C Diff across the country during the time of the Vale cluster, putting the incident into context. It reported 285 deaths linked to C Diff across the country in the six months from December 1, 2007. There are no directly comparable figures for the previous year, but there were 417 deaths for the whole of 2006.
Health Protection Scotland said only the Vale exceeded limits for the expected number of deaths where the bug was the main underlying cause and a contributing factor.
However, NHS Grampian is now investigating deaths linked to C Diff at Woodend Hospital in Aberdeen as the rate was higher than elsewhere.
The number of cases in NHS Grampian hospitals was also higher than expected for the six months studied and two other hospitals, one in Fife and one in Lanarkshire, broke expected limits in February.
Ms Sturgeon did not express surprise at the number of C Diff deaths nationwide, saying there were problems in Scotland as in other countries and the level was not above what might be expected. However, she added this did not make the figure "acceptable in any way shape or form".
David Logan, chairman of the C Diff Justice Group which has campaigned on behalf of families, said the review report had reflected some of their views. However, the group is still calling for a public inquiry.
Mr Logan, whose mother-in-law died at the Vale, said: "Only by bringing people under oath in a court of law will we get to the root of the cause of why this system failure resulted in these unnecessary deaths."
Following publication of the review, Tom Divers, chief executive of NHS GGC, said: "There are clearly lessons that have been learned and a clear need for me now, on behalf of NHS Greater Glasgow and Clyde, to apologise to the families affected by C Diff at the Vale of Leven Hospital."
He said action had already been taken on a number of fronts mentioned in the report and promised to bring forward proposals over the next two months which will set out a clear vision for the future of the Vale.
A spokeswoman for NHS Grampian said minimising the risk of infections, including C Diff, was a top priority.
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