C. diff warning issued months before deaths

Published on Saturday 21 June 2008 19:49

HEALTH chiefs in charge of tackling the hospital superbug Clostridium difficile warned four months ago that Scotland was failing to match tough new measures in England aimed at preventing deadly outbreaks.

Scotland on Sunday can reveal that senior officials at the country's main infection-control body, Health Protection Scotland (HPS), had deep concerns in February about "the lack of guidance in Scotland" on how hospitals should combat C. difficile

Their fears were prompted by a comprehensive 133-page report written by English health chiefs on how to prevent the bug taking hold in hospitals. The guidance, ordered in England more than 18 months ago, was not circulated north of the border because Scotland has a separate NHS structure.

Last night, Professor Hugh Pennington – one of the country's leading experts on infection control – said: "Bugs don't stop at Gretna. But the Department for Health in Scotland appears to have been far more laid-back than their counterparts in England. This guidance would have made a difference."

The new revelations follow the outbreak of C. difficile at Vale of Leven Hospital, near Glasgow, where nine patients have died since Christmas as a direct result of catching the bug. Nine other patients have died after contracting the virulent strain of the bug – known as type 027 – at Aberdeen Royal Infirmary and Stobhill Hospital, Glasgow.

Yesterday it emerged a ward at the Victoria Infirmary, Glasgow, had been closed to new admissions after three patients tested positive for C. difficile. A spokesman said the patients were being nursed in isolation, and none were giving cause for concern. Additional cleaning, and strict infection control measures, have been implemented, he added.

Commenting on the Vale of Leven outbreak, Health Secretary Nicola Sturgeon admitted last week that the surveillance systems at the hospital were "inadequate".

But attention is now focusing on the safeguards put in place by ministers and officials to protect the public at large.

In England, the Department of Health ordered its own infection body, the Health Protection Agency, to produce new guidance on C. difficile as far back as November 2006. It followed a devastating outbreak in Kent which left 90 people dead.

That guidance was published in February. A government document seen by Scotland on Sunday reveals that health protection officials in Scotland were immediately worried about the lack of equivalent guidance north of the border.

The document reveals that on February 14, one HPS official attended a meeting in London to study the new English guidance. "After returning from this meeting (the official] raised concerns … on the lack of CDAD (C. difficile-associated disease] guidance in Scotland."

Sturgeon's aides last night insisted those concerns had not been passed up to ministers or health department officials.

A source close to Sturgeon said: "This is the first time that we have been made aware of this. We are not aware of any Scottish minister being informed about this. As far as we are aware, there was no contact between the HPS and the Scottish Government on this."

Pennington said last night that had the guidance been provided to hospitals in Scotland the impact of the outbreak would have been lessened.

"The seriousness of the problem would have been much less and the number of deaths would have been much less," he said.

"Whichever way you look at it, they (England] have been more pro-active than the health department in Scotland."

A spokesman for the Scottish Government said that new guidance would be issued to hospitals before the Scottish Parliament returned for its summer recess in September.