R53 Response Accepted AI-assessed

Surveillance systems fit for purpose

Recommendation

Health Boards should ensure that surveillance systems are fit for purpose, are simple to use and monitor, and provide information on potential outbreaks in real time.

Published Evidence Summary
The following publicly available evidence relates to this recommendation:
According to Public Health Scotland / NSS (2025-09-01), national mandatory Clostridioides difficile infection (CDI) surveillance has been operational across NHS Scotland since 2006 for patients aged 65+ and 2009 for all patients aged 15+, with real-time surveillance systems in place and quarterly epidemiological data published. According to Public Health Scotland (2024-11-04), dedicated guidance was also published in November 2024 for the prevention and control of CDI in community-based settings, extending surveillance beyond hospitals. According to the Scottish Government's response, this recommendation was accepted in 2015.
How was this assessed?
Assessed by gemini-2.5-flash on 19 Mar 2026
Checked data held on this site (government responses, progress updates, independent evidence)
External sources searched: www.gov.uk, www.gov.scot, www.legislation.gov.uk, hansard.parliament.uk
This recommendation requires implementation across many organisations. The assessment reflects central policy response, not adoption in individual organisations.
Jurisdiction
Scotland
Response
Accepted
Accepted Scottish Government
18 Jun 2015

Section 2.1 of the Scottish Government's response details that national and local surveillance data are collected across a range of areas to support and monitor HAI policy, including data for HAI outbreaks. Section 4.2 further explains that eHealth initiatives, with significant investment in modern information technology systems, are improving record-keeping and data sharing. Systems like TrakCare and online clinical portals enable greater traceability of patients and the secure sharing of clinical information, enhancing the fitness for purpose and ease of monitoring of surveillance systems.

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Published Evidence

Published assessments of implementation progress from inspectorates, select committees, official progress reports, and other sources. Check the source type badge to see whether each assessment is independent or government self-reported.

Confirmed Completed
01 Sep 2025
Public Health Scotland / NSS Other

National mandatory CDI surveillance has been in place since 2006 (65+) and 2009 (all patients 15+). Dramatic decrease in CDI incidence rates since 2008. By 2018 rate was 0.27 per 1000 occupied bed days (below LDP target of 0.32). Quarterly epidemiological data continues to be published (most recent Q3 2025).

View detailed findings

Reporting methodology changed from per 1000 to per 100000 total occupied bed days in July 2019 to align with European standards. Real-time surveillance systems operational across NHS Scotland.

CDI Surveillance, National Services Scotland View Source
Good Progress
04 Nov 2024
Public Health Scotland Other

Public Health Scotland published first dedicated guidance on prevention and control of Clostridioides difficile infection in community-based settings in Scotland (November 2024). Extends CDI surveillance and control beyond hospital settings.

View detailed findings

New community guidance reflects evolution of CDI prevention beyond the acute hospital setting that was the focus of the Vale of Leven Inquiry.

Guidance on CDI in community-based settings, Nove… 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
Disease outbreak surveillance Care home infection control Infection Control Surveillance
Recommendation age 11.3 yrs
Last formal update 3932 days ago