Board Meeting 6/10/16 Open Session Item 11 Performance and Quality Report to the Board ober
Introduction This report summarises key areas of performance which includes, but is not limited to, Local Delivery Plan standards. This report also includes the Healthcare Associated Infection (HAI) performance report. As the HAI report follows a Scottish Government prescribed format, it is included in full as Appendix A. The overall approach adopted is that performance management is integral to the delivery of quality and effective management, governance and accountability. The need for transparent and explicit links of performance management and reporting within the organisational structure at all levels is important. The indicators noted below are a high level set of performance standards which are supported by a comprehensive framework of measures at directorate and service level. These are reported to and monitored by the relevant senior officers and their clinical and senior professional support staff. A summary of the overall performance is noted below. 2
A&E performance Responsive Target: 95% of patients are discharged or transferred within 4 hours of arrival for A&E treatment. On a cumulative monthly basis we have maintained performance against the 95% standard. Our Local Delivery Plan commits to ongoing delivery of 95% but aiming to improve further throughout the year. In the month of y : There were 11,807 attendances at A&E services across Grampian 8.9% of the total across Scotland. This represented a 1.9% increase compared with y. 96.8% of attendances at A&E services were seen and subsequently admitted, transferred or discharged within 4 hours compared to 95.8% across Scotland. 10 (0.1%) patients spent more than 8 hours in an A&E department compared to 0.2% across Scotland. No patient spent more than 12 hours in an A&E department compared to 19 (0.1%) patients across Scotland. 21.9% of attendances led to an admission to hospital compared to 24.7% across Scotland. For the year ending y : The total number of attendances was 138,823. This was 0.2% higher than for the same period one year previously and compared to a 1% increase across Scotland. The percentage spending 4 hours or less in an A&E department was 96.7% - up from 94.5% for the year ending y. It was also well above the Scotland wide rate of 94.5%. Delayed discharges The ISD publication on delayed discharges for y has just been published. These show the number of hospital bed days associated with delayed discharges for a full calendar month, and the number of patients classified as a delayed discharge at the monthly census. This is the first publication under new data definitions and national data requirements which came into effect on 1 y. The revised definitions ensure improved data quality and alignment of census information and associated bed days. This provides more robust and consistent reporting across Scotland. In y, patients spent 5088 days in hospital due to delays in discharge in Grampian 11.6% of the total across Scotland. There were 161 patients delayed at the y census. This is a 4% decrease on the previous month and contrasted with a 4% increase across Scotland. 29 (18%) of these delays were for patients with specific complex care needs. This compared to 21% across Scotland. Of the remaining 132 patients delayed at the census, 128 were due to health and social care reasons and four due to patient and family related reasons. The three Health and Social Care Partnerships have committed to ongoing improvement as part of the Local Delivery Plan. Key areas of focus include Hospital@Home (Aberdeen) 3
and the Virtual Ward (Aberdeenshire). There is fluctuation on a weekly basis as service capacity changes due to availability of home care and care home provision. The situation is closely managed with daily multidisciplinary and multi agency huddles to ensure the best possible solutions are found for individuals. Treatment Time Guarantee The number of patients reported as breaching the Treatment Time Guarantee at 31 st ch was 385, against a target of 359. We have committed to make best endeavours in /17 within resources available. We are reducing our reliance on independent providers and focusing on enhancing local capacity through improved theatre utilisation and other service redesign. Our most recent reported position is above the trajectory agreed within the Local Delivery Plan. The reasons for variation are known and differ by specialty. An access times action plan is in place and the inpatient position is still forecast to be within the LDP range (by ember) but at the upper limit of the agreed range. New outpatients patients seen within 12 weeks We will continue best endeavours to achieve the best outcome within available resources. Based on the demand and capacity modelling we have undertaken we forecast our performance to be in the range 7,299-9,060 1 by 31 ember. Our most recent reported position is already above trajectory. Recovery actions are in place for most specialties with areas of highest risk being orthopaedics, ENT and cardiology. Additional support is being provided by Scottish Government and we are looking at options to fund further capacity to improve the position. We continue to implement national initiatives such as DOIT (Delivering Outpatients Integration Together) to redesign services to deliver sustainably on the totality of demand, including return patients. Further work is to be undertaken locally to understand variation and changes in referral practice. Cancer Access Standards The 62 Day Standard is that 95% of patients urgently referred with a suspicion of cancer will wait a maximum of 62 days from referral to first cancer treatment. The 31 Day Standard is that 95% of all patients will wait no more than 31 days from decision to treat to first cancer treatment. The latest published data is for the quarter to ch with the quarter to e due to be published on 28 tember. We anticipate that the 31 day target will be delivered for the quarter to 30 e but there continue to be challenges in delivering the 62 day target. There is a short term endoscopy issue in the colorectal screening pathway which has a recovery plan in place to address the backlog by ember. The surgical capacity has improved with two consultants having been appointed to the vacant posts. In the breast cancer service there is has been a temporary loss in capacity. The service is taking all appropriate steps to secure additional capacity both from other NHS Boards and the independent sector. However securing capacity remains challenging and we expect that performance may be impacted for the foreseeable future. The service has developed a business plan to increase capacity but implementation will be dependent on being able to recruit to the posts. Both of these issues will impact on the 31 day and 62 day position until ember. 1 The number of patients per month who will be waiting longer than 12 weeks for an outpatient appointment 4
Access to Child and Adolescent Mental Health Services (CAMHS) During the quarter ending e, 442 children and young people started treatment at CAMH services in Grampian, an increase of 36 (8.9%) compared to the quarter ending ch. This was a much greater increase than the 3.2% recorded across Scotland. 41% of people were seen within 18 weeks, down from 56.4% the previous quarter. The position is caused by a number of recruitment challenges. A substantial service redesign is underway with local authority and third sector partners to deliver improvement across all aspects of the service. In the meantime the service continues to prioritise seeing emergency/urgent referrals and those who have waited the longest. GPs can request a case be reviewed at any time. There was a decrease in the CAMHS workforce in post in Grampian from 74 headcount (58.2 WTE) as at 31st ch to 66 headcount (52.2 WTE) as at 30th e. An additional 8.5 WTE posts throughout NHS Grampian CAMHS have however been advertised and filled in recent months. In addition to the funding made available by Scottish Government Mental Health Funding Improving access to CAMHS Fund and Mental Health Innovation Fund, the NHS Grampian Board will consider further investment in additional staff capacity as part of the financial plan for 2017/18. 5
Well Led Financial performance period to 31 y Revenue The results for the first five months are in line with expectations. An overspend of 3.5m has been recorded against the revenue budget for the first five months. The main areas of cost pressure are in relation to medical locum expenditure and continuing overspends within mental health and the acute sector. The results exclude Integration Joint Board performance as they are expected to perform within the resources allocated to them. Some known pressures within Aberdeenshire are being closely managed. Actions are being taken to reduce the level of medical locum expenditure, including demand management solutions and improving the arrangements for procuring and engaging locums. New Clinical Development Fellow posts are also being established with a view to supporting rota compliance in a number of areas. Cost pressures have been identified and are being actively managed. Capital The total capital programme for /17 stands at 57m. The largest single commitment is the Phase 2 Backlog Maintenance work at Aberdeen Royal Infirmary ( 11.9 million). Other schemes in the plan include the creation of the multi storey car park at ARI ( 10.4 million financed from donations), replacement of medical equipment ( 4.7 million), reprovision of Denburn Health Centre and creation of a new Aseptic Pharmacy. As would be expected at this point in the financial year, there has only been a low level of capital spend to date ( 5.3m) which has mainly been incurred on backlog maintenance, aseptic pharmacy and medical equipment. 6
Effective Detect Cancer Early 20.1% of people were diagnosed with breast, colorectal and lung cancer at the earliest stage (stage 1) in Grampian during 2014 and. This is below the rate of 25.1% across Scotland and there has been no improvement from the baseline years of 2010 and 2011 (20.2%) whereas there was improvement from 23.2% across Scotland. For individual cancers the proportion diagnosed at stage 1 were as follows Breast: 35.9% compared to 40.5% across Scotland Colorectal: 10.9% compared to 15.4% across Scotland Lung: 12.1% compared to 17.9% across Scotland. 13.0% of patients were recorded with a not known stage of disease compared to only 5.5% across Scotland. There is awareness of Grampian s position in relation DCE and this has been the subject of detailed discussion with the Scottish Government. The initiatives undertaken by NHS Grampian are similar to those in other Board areas and are approved by the Scottish Government. In order to improve our intelligence in this area, a study is planned to examine the factors which may inhibit early diagnosis to inform the debate regarding the next stages of DCE. Additionally performance reports are being compiled for each cancer site looking at care across the entire pathway. Smoking Cessation The /16 target for smoking cessation was not met. The target was for 955 smokers from the most deprived communities in Grampian to have quit smoking for a minimum of three months. A total of 811 adults who successfully reported stopping smoking at 12- week follow-up were eligible to count against the target, representing 85% of the target. However an additional 162 smokers were known to have also successfully stopped smoking at 12-weeks, but could not be included in the on-line recording system due to a peculiarity in the recording system design. Scottish Government is aware of this. The LDP smoking cessation standard remains in place for /17, although the target has been increased by 20% to 1,145. Adults in Grampian can receive support to stop smoking through community pharmacies or through primary care referrals to a specialist public health team. In /16 a total of 5,959 adults were recorded as attempting to stop smoking through one of these services. Of these 3,548 (60%) lived in a postcode area eligible to count towards the target. In turn 811 were recorded as being successfully stopped smoking at 12-weeks follow-up. Significant effort is going in to ensure that the LDP target in /17 is achieved: attention to the recording system will improve follow-up data capture additional targeted specialist support is being provided to community pharmacies to improve their quit rates 7
additional resources are being provided to HMP Grampian and antenatal settings to increase recruitment amongst the target population potential partnership working with e-cigarette retailers in Grampian is being explored as a non-conventional way to provide additional reach for cessation services 8
Safe Healthcare Associated infection Performance against the HAI standards for MRSA/MSSA and Cdifficile has shown deterioration in recent months. MRSA/MSSA is now close to the Scottish average having previously been much better. Cdiff is above the Scottish average. A full report was presented to the Clinical Governance Committee in ust. A comprehensive action plan has been developed including Protocol developed for gathering case definition information at time of phoning result Protocol in development for prescribing Fidaxomicin for recurrent CDI (as per national guidelines) Early analysis of - data to ensure that rates return to within normal limits This action plan is regularly reviewed and monitored by the Infection Prevention and Control Committee. The full HAI report is attached as Appendix A. 9
Other Intelligence This section of the report contains information and intelligence on aspects of care which are not monitored formally through targets. Drawn from Scotland-wide publications, particularly national audits, the aim of including them here is to provide a more holistic picture of quality and performance. They highlight good comparable service delivery performance and indicate improvements in health outcomes. Bowel Screening For the two-year period ember 2013 to ober : Uptake in Grampian was 62.6% compared to 57.5% across Scotland. Uptake for females was 66.4% and for males was 58.9%. Both figures were above the Scotland wide rates of 60.5% and 57.5%, respectively. The Healthcare Improvement Scotland standard for bowel screening uptake is 60%. Uptake was lower in areas of higher deprivation. Uptake in the most deprived groups was 44.6% compared to 68.1% in the least deprived group. This was a marginally wider gap than across Scotland as a whole where the equivalent figures were 45.1% and 66.5%, respectively. Cancelled Operations In the month of y The total number of planned operations across NHS Grampian was 2709. Of these, 8.9% of operations were cancelled either by the hospital or by the patient. This was equal to the Scotland wide rate of 8.9%%. Of all planned operations, 3.9% (3.8% in Scotland) were cancelled by the patient, 2.3% (3.0% in Scotland) were cancelled on clinical reasons by the hospital and 2.2% (1.7% in Scotland) were cancelled by the hospital due to capacity or nonclinical reasons. 10
Healthcare Associated Infection Appendix A Summary position Issue Group Target Period & source SABs All ages Local Delivery Plan Standards 24 cases per 100,000 AOBD CDIs MRSA (CRA) screening Hand Hygiene Cleaning Estates Patients aged 15 and over All clinical areas Local Delivery Plan Standards 32 cases per 100,000 TOBD HPS 90% SGHD 90% HFS 90% HFS 90% NHS Scot No new published national data No new published national data -, HPS -, NHSG -, HFS -, HFS NHS G RAG Amber (status as last report) Red (status as last report) 82% 91% Green Not available 97% Green 95% 94% Green 97% 96% Green Antimicrobial prescribing Hospital downstream medical wards (ARI,110, 111, ) Hospital downstream surgical wards (ARI 205) Surgical Antibiotic prophylaxis (Neurosurgery) SAPG 95%- doses admin SAPG 95%- Indication documented SAPG 95%- duration/review documented SAPG 95%- policy compliant SAPG 95%- doses admin SAPG 95%- Indication documented SAPG 95%- duration/review documented SAPG 95%- policy compliant SAPG 95% - single dose SAPG 95% - policy compliant -, NHSG -, NHSG - NHSG NA 96% Green NA 96% Green NA 84% Amber NA 100% Green NA 100% Green NA 80% Amber NA 60% Red NA 75% Amber NA 35% Red 72% Amber 11
Surgical Site Infections (SSIs) antibiotic prescribing (primary care) Caesarean Section Hip Arthroplasty SAPG 50% GP practices at or moved towards target n/a n/a -, PRISMS NA 92% Green No new published national data No new published national data Green (status as last report) Green (status as last report) 12
Section 1 Staphylococcus aureus (including MRSA) Bacteraemia Enhanced Staphylococcus aureus Bacteraemia (SAB) Surveillance Enhanced SAB surveillance is carried out in all Health Boards using standardised data definitions. Each new case continues to be discussed at a weekly multidisciplinary team meeting involving Infection Prevention and Control Doctors, Infection Prevention and Control Nurses, Surveillance Nurse, Antimicrobial Pharmacist, Infection Unit Nurse and a microbiology registrar. The offer of attendance at speciality case review meetings from the IPCT is extended should further discussion be required. Cases are defined as: Hospital Acquired Healthcare Associated Community Associated Not Known Since the last HAI report, no new collated results for NHS Scotland have been published. National Staphylococcus aureus bacteraemia surveillance programme Health Protection Scotland is due to publish its quarterly reports on the surveillance of Staphylococcus aureus bacteraemia (SAB) in Scotland, il to e in ober. More information on the national surveillance programme for Staphylococcus aureus bacteraemias can be found at: http://www.hps.scot.nhs.uk/haiic/sshaip/publicationsdetail.aspx?id=30248 MRSA Screening In early 2011, the Scottish Government announced new national minimum MRSA screening recommendations. Targeted MRSA screening by specialty (implemented in uary 2010) has now been replaced by a Clinical Risk Assessment (CRA) followed by a nose and perineal swab (if the patient answers yes to any of the CRA questions). National Key Performance Indicators (KPIs) have now been implemented with Boards being required to achieve 90% compliance with CRA completion. CRA compliance for Quarter 1 (uary-ch ) within NHS Grampian was 91%. This is the first time NHS Grampian has achieved compliance with the KPI. Health Board _16 Q2 _16 Q3 _16 Q4 _17 Q1 Grampian 79% 88% 74% 91% Scotland 78% 83% 80% 82% 13
Clostridium difficile Infection Clostridium difficile Infection Surveillance As with S aureus bacteraemias, each new case is discussed at a weekly multidisciplinary team meeting involving Infection Prevention and Control Doctor(s), Infection Prevention and Control Nurses, Surveillance Nurse, Antimicrobial Pharmacist, and a microbiology registrar the Infection Unit Nurse is not present for the CDI case discussions. By close investigation of each case and typing of the organisms when indicated the Infection Prevention and Control Team is assured that the recent increase in infections is not due to any outbreaks. Local enhanced surveillance data can be provided in a more timely fashion as this is not part of a national enhanced surveillance programme. During quarter 1 (uary-ch ): 46% cases were classified as healthcare associated 54% cases were classified as out of hospital National Clostridium difficile infection surveillance programme Health Protection Scotland are also due to publish their quarterly reports on the surveillance of Clostridium difficile infections (CDIs) in Scotland, il to e in ober. Information on the national surveillance programme for Clostridium difficile infections can be found at: http://www.hps.scot.nhs.uk/haiic/sshaip/ssdetail.aspx?id=277 Cleaning and the Healthcare Environment Health Facilities Scotland National Cleaning Specification Reports NHS Grampian continues to achieve the required cleanliness standards across all locations as monitored by the Facilities Monitoring Tool. No new national data have been received. Incidents and Outbreaks Norovirus Prevalence Monday Point Prevalence Surveillance figures are reported to Health Protection Scotland. These capture the significant outbreaks of Norovirus in NHS Grampian and the prevalence of norovirus activity in close to real time. They are not, and should not be interpreted as data for benchmarking or judgement. The data can be used for the assessment of risk and norovirus outbreak preparedness only. During e and y the following wards or bays were closed due to Norovirus during Monday Point Prevalence: On Monday 6 e, 1 hospital had 1 ward closed with 1 patient affected On Monday 18 y, 1 hospital had 1 ward closed with 3 patients affected 14
Data on the numbers of wards closed due to confirmed or suspected norovirus are available from HPS on a weekly basis at: http://www.hps.scot.nhs.uk/haiic/ic/noroviruspointprev.aspx Other HAI Related Activity Antimicrobial Prescribing Acute sector Hospital downstream ward All national Antimicrobial Prescribing Indicators to support the CDI HEAT target for acute hospitals have now been revised by the Scottish Antimicrobial Prescribing Group (SAPG) and aligned with the second Scottish Management of Antimicrobial Resistance Action plan (ScotMARAP 2; 2014-18) priority areas as well as the Healthcare Improvement Scotland Healthcare Associated Infection (HAI) Standards ( ). Data is collected from 5 patients per week on antibiotics and the following measures are assessed: all prescribed doses have been administered, indication documented, duration/ review documented, antibiotic choice in line with guidelines. The target is > 95% for each measure. Data presented in this report reflects the average of local performance in y &. Data collection includes two medical wards and one surgical ward. Surgical prophylaxis Measures assessed are: duration of surgical antibiotic prophylaxis is less than 24 hours (single dose for most specialities) and antibiotic(s) compliance with policy is > 95% for each measure. No new data has been collected since e pending changes to the neurosurgery prophylaxis guidelines (in progress). Primary Care antibiotic prescribing Target is for total antibiotic prescribing rate to be 1.8 items per 1000 patients per day or less, with at least 50% of GP practices meeting the target or having made an acceptable shift towards the target. The Q1-17 data shows that 91.9% of GP practices in NHSG have either met or made an acceptable shift towards the Q4 target originally set in 2013. However, it should be noted that Q1 is always lower for antibiotic prescribing than Q4 due to seasonal trends. 15
Section 2 Healthcare Associated Infection Report Cards The following section is a series of Report Cards that provide information, for each acute hospital and key community hospitals in the Board, on the number of cases of Staphylococcus aureus blood stream infections (also broken down into MSSA and MRSA) and Clostridium difficile infections, as well as hand hygiene and cleaning compliance. In addition, there is a single report card which covers all community hospitals [which do not have individual cards], and a report which covers infections identified as having been contracted from outwith hospital. The information in the report cards is provisional local data, and may differ from the national surveillance reports carried out by Health Protection Scotland and Health Facilities Scotland. The national reports are official statistics which undergo rigorous validation, which means final national figures may differ from those reported here. However, these reports aim to provide more detailed and up to date information on HAI activities at local level than is possible to provide through the national statistics. Understanding the Report Cards Infection Case Numbers Clostridium difficile infections (CDI) and Staphylococcus aureus bacteraemia (SAB) cases are presented for each hospital, broken down by month. Staphylococcus aureus bacteraemia (SAB) cases are further broken down into Meticillin Sensitive Staphylococcus aureus (MSSA) and Meticillin Resistant Staphylococcus aureus (MRSA). More information on these organisms can be found on the NHS24 website: Clostridium difficile : http://www.nhs24.com/content/default.asp?page=s5_4&articleid=2139§ionid=1 Staphylococcus aureus : http://www.nhs24.com/content/default.asp?page=s5_4&articleid=346 MRSA: http://www.nhs24.com/content/default.asp?page=s5_4&articleid=252§ionid=1 For each hospital the total number of cases for each month are those which have been reported as positive from a laboratory report on samples taken more than 48 hours after admission. For the purposes of these reports, positive samples taken from patients within 48 hours of admission will be considered to be confirmation that the infection was contracted prior to hospital admission and will be shown in the out of hospital report card. Targets There are national targets associated with reductions in C.diff and SABs. information on these can be found on the Scotland Performs website: More http://www.scotland.gov.uk/about/performance/scotperforms/partnerstories/nhsscotland performance Understanding the Report Cards Hand Hygiene Compliance Hospitals carry out regular audits of how well their staff are complying with hand hygiene. Each hospital report card presents the combined percentage of hand hygiene compliance with both opportunity taken and technique used broken down by staff group. 16
Understanding the Report Cards Cleaning Compliance Hospitals strive to keep the care environment as clean as possible. This is monitored through cleaning and estates compliance audits. More information on how hospitals carry out these audits can be found on the Health Facilities Scotland website: http://www.hfs.scot.nhs.uk/online-services/publications/hai/ Understanding the Report Cards Out of Hospital Infections Clostridium difficile infections and Staphylococcus aureus (including MRSA) bacteraemia cases are all associated with being treated in hospitals. However, this is not the only place a patient may contract an infection. This total will also include infection from community sources such as GP surgeries and care homes and. The final Report Card report in this section covers Out of Hospital Infections and reports on SAB and CDI cases reported to a Health Board which are not attributable to a hospital. 17
NHS BOARD REPORT CARD NHS Grampian Staphylococcus aureus bacteraemia monthly case numbers MRSA MSSA SABS 0 0 0 0 0 0 0 0 1 0 0 0 7 10 13 16 16 11 16 11 12 11 9 11 7 10 13 16 16 11 16 11 13 11 9 11 Clostridium difficile infection monthly case numbers 15-64 65+ 15+ 4 4 9 6 7 7 9 6 2 8 2 2 6 7 12 8 11 14 7 7 6 4 7 11 10 11 21 14 18 21 16 13 8 12 9 13 Hand Hygiene Monitoring Compliance (%) AHP 98 98 98 99 98 96 98 99 98 99 97 99 Ancillary 96 94 97 94 93 96 92 91 95 92 97 95 Medical 95 95 94 95 95 94 95 97 94 95 95 95 Nurse 98 97 98 98 97 97 97 97 97 98 98 98 98 97 97 97 96 97 96 97 96 97 97 98 Cleaning Compliance (%) Board 94 94 94 94 95 95 94 94 94 94 95 94 Estates Monitoring Compliance (%) Board 96 97 96 96 97 97 96 96 96 96 96 96 18
NHS HOSPITAL A REPORT CARD Aberdeen Royal Infirmary Staphylococcus aureus bacteraemia monthly case numbers MRSA 0 0 0 0 0 0 0 0 0 0 0 0 MSSA 1 4 1 4 6 4 6 5 5 3 3 4 SABS 1 4 1 4 6 4 6 5 5 3 3 4 Clostridium difficile infection monthly case numbers 15-64 65+ 15+ 0 1 3 1 3 1 2 2 1 3 0 0 3 4 4 2 2 5 2 4 3 1 1 5 3 5 7 3 5 6 4 6 4 4 1 5 Cleaning Compliance (%) ARI 94 94 94 95 95 94 94 94 94 94 94 97 Estates Monitoring Compliance (%) ARI 97 98 98 98 97 98 98 97 96 97 98 96 19
NHS HOSPITAL B REPORT CARD Dr Gray s Hospital Staphylococcus aureus bacteraemia monthly case numbers MRSA 0 0 0 0 0 0 0 0 0 0 0 0 MSSA 0 1 1 0 0 0 0 0 3 0 0 0 SABS 0 1 1 0 0 0 0 0 3 0 0 0 Clostridium difficile infection monthly case numbers 15-64 65+ 15+ 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 1 1 0 2 0 0 1 0 0 0 Cleaning Compliance (%) ARI 94 94 94 94 94 94 94 94 95 94 94 94 Estates Monitoring Compliance (%) ARI 96 95 94 96 96 96 95 95 95 94 95 94 20
NHS HOSPITAL B REPORT CARD Woodend Hospital Staphylococcus aureus bacteraemia monthly case numbers MRSA 0 0 0 0 0 0 0 0 0 0 0 0 MSSA 0 1 0 1 0 0 1 0 0 0 0 0 SABS 0 1 0 1 0 0 1 0 0 0 0 0 Clostridium difficile infection monthly case numbers 15-64 65+ 15+ 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 0 0 1 0 2 0 0 0 0 0 0 0 Cleaning Compliance (%) ARI 94 93 94 95 95 94 95 95 95 94 95 94 Estates Monitoring Compliance (%) ARI 94 95 93 96 95 99 96 95 96 94 93 94 21
OTHER NHS HOSPITALS REPORT CARD The other hospitals covered in this report card include: Aberdeen Maternity Hospital Royal Cornhill Hospital Royal Aberdeen Children's Hospital Roxburgh House All Community Hospitals Staphylococcus aureus bacteraemia monthly case numbers MRSA 0 0 0 0 0 0 0 0 0 0 0 0 MSSA 0 1 0 2 0 0 0 0 0 0 1 0 SABS 0 1 0 2 0 0 0 0 0 0 1 0 Clostridium difficile infection monthly case numbers 15-64 65+ 15+ 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 1 NHS OUT OF HOSPITAL REPORT CARD Staphylococcus aureus bacteraemia monthly case numbers MRSA 0 0 0 0 0 0 0 0 1 0 0 0 MSSA 6 3 11 11 10 7 9 6 4 8 5 7 SABS 6 3 11 11 10 7 9 6 5 8 5 7 Clostridium difficile infection monthly case numbers 15-64 65+ 15+ 4 3 6 4 3 5 7 4 0 5 2 1 3 3 6 5 4 5 5 3 3 2 4 6 7 6 12 9 7 10 12 7 3 7 6 7 22