The Scottish Government's Response to the Vale of Leven Hospital Inquiry Report

Footnotes

1. While the focus of our response is acute hospitals (such as the VOLH), the principles of HAI policy and infection prevention and control practice apply equally across all care settings, including GP and dental surgeries, care homes and community hospitals. We expect the same high standards of infection control and prevention practice to be followed in settings such as these.

2. The HEI can "escalate" matters of concern via formal and informal routes. The severity of the issue determines how and to whom the concern will be escalated. In some circumstances, the HEI may pursue formal escalation of a serious issue without first engaging in informal escalation activity with the NHS board.

3. The target rate is 0.32 cases (or fewer) of C. diff infection per 1000 total occupied bed days.

4. Source: Resar R, Pronovost P, Haraden C, Simmonds T, et al. Using a bundle approach to improve ventilator care processes and reduce ventilator-associated pneumonia. Joint Commission Journal on Quality and Patient Safety. 2005;31(5):243-248.

5. MRSA - meticillin-resistant Staphylococcus aureus - is a type of infection that is resistant to a number of widely used antibiotics, making it more difficult to treat.

6. Sometimes known as the "winter vomiting bug".

7. Leading Better Care is also applicable and transferable to community-based team leaders and lead midwives. Individual boards have included aspiring charge nurses, managers and allied health professionals in their Leading Better Care activities.

8. Available at: http://www.healthcareimprovementscotland.org/our_work/governance_and_assurance/programme_resources/nhs_lanarkshire_review.aspx

9. Available at: http://www.healthcareimprovementscotland.org/our_work/governance_and_assurance/programme_resources/ari_review.aspx

10. Available at: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/408480/47487_MBI_Accessible_v0.1.pdf

11. "Cohorting" refers to the grouping of infectious patients and nursing them within a specified area of a hospital ward.

12. The quarterly compliance reports grade each NHS board using a traffic light system of: Red (compliance below 70%); Amber (between 70% and 90%); and Green (compliance above 90%).

13. The measurement of backlog maintenance represents a snapshot in time. The risk category is reviewed regularly. Items identified as "low-risk" can become "high-" and "significant-risk" items over time if unaddressed.

14. Available at: http://www.midstaffspublicinquiry.com/

15. The NHS Pay Review Body deals with the salaries and terms and conditions of many NHS staff, including nurses, midwives, pharmacists and administrative staff.

16. Healthcare support workers are those who are not subject to regulation by a professional regulatory body and whose role has a direct link with patients and members of the public. In addition to those working in direct contact with patients in clinical areas, it also includes workers with access to patient data and those who provide non-clinical services, such as servicing equipment and delivering goods or services to patients.

17. This includes dentists, clinical dental technicians, dental hygienists, nurses, technicians and therapists, and orthodontic therapists.

18. Whole time equivalent (WTE) is an estimate of the staff available, taking into account full- and part-time working.

19. Internships form part of our One Year Job Guarantee, which aims to support nurses' and midwives' transition into employment following their undergraduate programmes. Intern positions are available to all eligible newly qualified nurses and midwives who are registering to practice for the first time and who have not yet been able to find a post through their own endeavours. Internships involve part-time (22.5 hours per week) employment in clinical practice in an NHS board, with rotational placements possibly including work in hospital, community, public health and/or care home settings. This allows interns to gain important clinical experience and consolidate skills and competence through care delivery in clinical areas.

20. While there is a clear difference between gagging and confidentiality clauses, it was recognised that there could be a perception that confidentiality clauses were being used to prevent staff from speaking out about failures in care offered to patients.

21. Updated guidance for doctors on reporting deaths to the Procurator Fiscal was provided by the Crown Office andamp; Procurator Fiscal Service in September 2014.

22. Formerly the General Register Office for Scotland.

23. The education, training and development needs of all NHSScotland staff are important and are being addressed through a range of measures at national and NHS board levels. Our focus here, however, is on nurses and doctors, as the need for specific measures relating to the education, training and development of these professionals is raised in several report recommendations.