What assessment has the Minister made of any gaps in the ICNET database, including the reporting of deaths from hospital-acquired infections?
Health boards and trusts have begun to undertake investigations into hospital-acquired infections under the Putting Things Right (PTR) process. To date, the number of completed investigations has not been collated centrally. The additional funding announced to support the programme of investigation work will enable the NHS Wales Delivery Unit to collate and monitor data at a national level. This will include data on the number of investigations undertaken.
The NHS Wales national framework – Management of patient safety incidents following nosocomial transmission of COVID-19 (the framework) reiterates the requirements of the PTR process in the context of COVID-19. It was developed to help support organisations apply PTR during the pandemic and promote consistency of approach to PTR across Wales. The framework supports the Communicable Disease Outbreak Plan for Wales (2020) by providing a consistent approach for NHS Wales organisations to identify, review and report patient safety incidents following nosocomial transmission of COVID-19 in compliance with the National Health Service (Concerns, Complaints and Redress Arrangements) (Wales) Regulations 2011 – Putting Things Right.
The NHS Wales Delivery Unit will play a key role in overseeing and monitoring implementation of the Framework. The governance structure to oversee this programme of work is in development. It is expected that a programme board will be established, through which, outcomes will be reported and monitored.
Investigations are being undertaken by appropriately trained staff in all health boards and trusts where nosocomial COVID-19 infection occurred.
The £4.54m funding over two years, which I recently announced is specifically to deliver the programme of work to investigate cases of hospital acquired COVID-19 infections. £4m will be allocated to health boards and trusts to enable them to deliver the investigation programme at pace and up to £540k will be allocated to the NHS Wales Delivery Unit to support the consistent implementation of the Framework.
The Wales ICNet system is used by infection prevention control (IPC) teams for case management and local surveillance and by Public Health Wales for national surveillance. The admissions data from ICNet has been used for the surveillance of COVID-19 admissions, COVID-19 hospital inpatients and nosocomial COVID-19. ICNet holds data on the date of patient death but not cause of death. IPC teams and the health board/trust mortality and morbidity review process determines whether a death is as a result of a healthcare associated infection.
In relation to actions in the Quality and Safety Framework, the Deputy Chief Medical Officer for Wales wrote to health boards and trusts at the start of the pandemic indicating that PTR arrangements should still be complied with. It was acknowledged that there may be delays due to corporate staff being redeployed to provide front line care, but complainants should be kept informed about the
progress of their concern. The requirement to consider the most appropriate way of involving the complainant in the investigation is set out in the PTR Regulations, and is unchanged. If a person is dissatisfied with the way in which their concern has been dealt with under the PTR process, they may raise their concern with the Public Services Ombudsman for Wales.