The recently published Vale of Leven Hospital Inquiry Report has revealed that 143 patients tested positive for Clostridium difficile infection (CDI) at the hospital during the period January 2007 to 31st December 2008, and CDI was a factor in the deaths of 34 of those patients.

The report identifies a number of failings, including:

• Governance and management failures within NHS Greater Glasgow and Clyde, which created an environment in which patient care was compromised and infection prevention and control was inadequate.
• Inadequate attention given by NHS Greater Glasgow and Clyde and the Scottish Government agencies to reports about other CDI outbreaks in the UK that identified failures similar to many of those at Vale of Leven Hospital.
• Significant deficiencies in infection prevention and control practices and systems that had a profound impact on the care provided to patients in the hospital.
• Deficiencies in nursing care and medical care, which seriously compromised the care of patients.
• Uncertainty over the Hospital’s future that had damaging effects on recruitment, staff morale and the hospital environment.
• Lack of strong management, which contributed to a culture unsuited to a caring and compassionate hospital environment.

The report makes 75 recommendations including recommendations on infection prevention and control, nursing and medical care, antibiotic prescribing, communication with patients and relatives, and death certification.

Health Secretary Shona Robison has apologised to the patients and families affected by the Vale of Leven outbreak, and says that the Government has accepted all recommendations in the inquiry report. It also intends to establish an implementation group to take them forward, with strong input from the families affected.

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