R37 Response Accepted

CDI senior assessment and treatment

Recommendation

Health Boards should ensure that any patient with suspected CDI receives full clinical assessment by senior medical staff, that specific antibiotic therapy for CDI is commenced timeously.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
- The Scottish Government published its response to the Vale of Leven Hospital Inquiry Report on 18 June 2015, accepting all 75 recommendations and establishing an Implementation Group chaired by the Chief Nursing Officer (Scottish Government Response, June 2015).
- Scotland's Health Protection Scotland (now ARHAI Scotland) developed clinical guidance for CDI management, including the requirement for prompt senior medical assessment and timely commencement of specific antibiotic therapy.
- The NIPCM includes guidance on the clinical management of CDI, and the Scottish Antimicrobial Prescribing Group provides prescribing guidance for CDI treatment (National Infection Prevention and Control Manual for Scotland (https://www.nipcm.hps.scot.nhs.uk/about-the-manual/)).
- NHS board antimicrobial management teams are responsible for ensuring CDI treatment protocols are followed, with surveillance data monitoring treatment timeliness and outcomes.
Sources
How was this evidence gathered?
Evidence searched by Claude (Anthropic) on 10 Apr 2026
Checked data held on this site (government responses, progress updates, independent evidence)
This recommendation applies across many organisations. The evidence above reflects central policy activity; adoption in individual organisations may vary.
Jurisdiction
Scotland
Response
Accepted
Accepted Scottish Government
18 Jun 2015

Section 4.1 of the Scottish Government's response acknowledges that recommendation 37 addresses delays in diagnosing and treating C. diff infection. Section 2.1 details that Scotland's Health Protection Network published C. diff guidance, revised in 2014, which outlines roles, responsibilities, and best practice on antimicrobial treatment. Additionally, NHS boards are supported with tools such as a C. diff testing protocol, a severe case investigation tool, a C. diff 'care bundle' for improving patient outcomes, and a 'trigger tool' to promptly identify problems and areas for improvement in patient care and antimicrobial prescribing.

Read Full Response
Published Evidence

Published assessments of progress from inspectorates, select committees, official progress reports, and other sources. Source type badge indicates whether each assessment is independent or government self-reported.

Good Progress
11 Jul 2022
ARHAI Scotland / NIPCM Other

NIPCM provides detailed clinical guidance on CDI assessment and treatment including requirement for senior medical assessment. Antimicrobial prescribing guidance from SAPG addresses timely CDI-specific antibiotic therapy.

View detailed findings

Clinical guidance on CDI management is comprehensive through the NIPCM and SAPG frameworks.

National Infection Prevention and Control Manual … View Source
Source
Inquiry Vale of Leven Inquiry
Report The Vale of Leven Hospital Inquiry Report 24 Nov 2014
View Source
Responsible Bodies
NHS Health Boards (Scotland) Primary
Themes & Tags
Delayed patient infection risk notification AMR and health inequalities data Treatment Medical C.difficile
Recommendation age 11.5 yrs
Last formal update 4000 days ago