Surveillance systems fit for purpose
Vale of Leven Inquiry · The Vale of Leven Hospital Inquiry Report · Issued 24 November 2014 · Addressed to: NHS Health Boards (Scotland)
Source — verbatim from the inquiry
●Inquiry 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.
Vale of Leven Inquiry, The Vale of Leven Hospital Inquiry Report · 24 Nov 2014 Source PDF →
Published evidence summary
Publicly available evidence relating to this recommendation:
- The Scottish Government's response detailed national and local surveillance data collection, including mandatory CDI surveillance (started 2006 for patients aged 65+, extended April 2009 to all aged 15+). The LDP standard requires CDI rates of 0.32 or less per 1,000 total occupied bed days.
- Scotland achieved a CDI rate of 0.27 per 1,000 occupied bed days in the year ending December 2018, meeting the target with a decreasing year-on-year trend of 7.5% between 2014 and 2018.
- The requirement that surveillance systems are fit for purpose and provide real-time outbreak information is addressed through national surveillance systems operated by ARHAI Scotland (formerly Health Protection Scotland) and local audit requirements within the HAI Standards.
- The HCAI Strategy 2023-2025 maintains surveillance and reporting as core elements of Scotland's approach to HAI reduction (Scottish HCAI Strategy 2023-2025 (https://www.gov.scot/publications/scottish-healthcare-associated-infection-hcai-strategy-2023-2025/)).
Response — verbatim from government
●Scottish Government
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.
Scottish Government · 18 Jun 2015 Written response →
Evidence trail — what's actually happened since
- 1 Sep 2025 · Public Health Scotland / NSS 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 source → Confirmed Completed
- 4 Nov 2024 · Public Health Scotland 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 source → Good Progress
Each entry above links to a primary source — gov.uk written statement, consultation response document, or inspection report. The Index does not characterise government intent; it tracks what has been published.
How this page is built
Source and Response are verbatim from primary documents. The Evidence trail records published activity since — written statements, consultation outcomes, inspection findings, parliamentary references. The Index does not paraphrase or characterise intent; it tracks what has been published. Where the evidence is the absence of action (a missed deadline, a slipped timetable), that absence is documented from primary sources rather than inferred.
This recommendation's data is verified periodically against primary sources. The Index is monitored for staleness weekly.