Scots health boards may struggle to reduce bugs
The Scottish Government has set ambitious targets to further cut rates of MRSA and Clostridium difficile after the downward trend in infections seen in recent years started to slow.
But in a letter to boards, Chief Medical Officer Harry Burns and Chief Nursing Officer Ros Moore acknowledged that some areas had concerns that the way the target was measured may not be appropriate for them and would make it difficult to achieve the reductions required.
A new target for delivery in 2014/15 states that boards should reduce C difficile infections in patients over 15 to 0.25 cases per 1,000 hospital bed days.
At the end of last year the rate for Scotland stood at 0.31, but with wide variations across the country. The Golden Jubillee in Clydebank had a rate of 0.08, while higher levels were seen in Borders (0.44), Ayrshire and Arran (0.42) and Tayside (0.42).
Another target aims to cut staphylococcus aureus bacteraemia (SAB) cases, which include MRSA, to 0.24 cases per 1,000 bed days. The rate at the end of last year stood at 0.30 across Scotland, with the highest rates seen in Fife (0.48), Forth Valley (0.37) and Tayside (0.36).
In their letter, Sir Harry and Ms Moore said the targets has been set because their remained the potential for further improvements to be made in cutting infections.
“However, we acknowledge that some boards have concerns that the denominator chosen may not be appropriate at a local level and may make it unduly difficult for them to achieve the target,” it said.
The letter said boards could write to the Scottish Government with evidence “that the denominator rather than lack of success in reducing SABs had impacted on delivery”.
“Otherwise, since the target for 2015 has now been set, our collective focus and ownership should be on reducing SABs and that each board should work towards a continuing downward trend,” it added.
Health Secretary Alex Neil said: “We are committed to delivering quality NHS services and Healthcare Associated Infections levels have reduced significantly over recent years – in part through agreeing and setting ever more stretching targets for NHS Boards.
“The latest quarters statistics on C.diff show reductions of over 82 per cent compared to 2007 and the number of infections at the lowest level since surveillance began.”