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1. A national framework for HAI surveillance should be established for the NHSiS. This framework should be developed by the Scottish Centre for Infection Control and Environmental Health (SCIEH), in conjunction with the NHS Management Executive and the professions, using this report as a basis for discussion, (paragraph 93).
2. The framework should include agreed, precise definitions to be adhered to by all participants in the surveillance system, and should take account of developments in other parts of the UK in order to allow for direct comparison of data, wherever possible, (paragraph 90).
3. As an interim arrangement, in advance of the establishment of a national system of HAI surveillance, Health Improvement Programmes (HIPs) and Trust Implementation Plans (TIPs) should give explicit consideration to the problem of HAI, consistent with the need to protect and promote health, (paragraph 94).
4. In due course, Health Boards and Trusts should put in place locally agreed review arrangements to ensure that the monitoring information produced by SCIEH is acted upon, (paragraph 95)
5. Initial surveillance projects should focus on auditing the incidence of HAI following elective Caesarean section and inguinal hernia repair. Regardless of the areas chosen, all projects should be piloted to ensure feasibility and robustness of methodology before adoption on a national basis, (paragraph 98).
6. CRAG should give serious consideration to extending the current national audit of morbidity and recurrence rate following hernia repair to include audit of HAI surveillance data, (paragraph 99).
7. SCIEH should establish links with all Scottish Trusts, including Primary Care Trusts (PCTs), to develop mechanisms for the accurate measurement of HAI post-discharge as part of the national surveillance system, (paragraph 101).
8. Health Service managers should give consideration to the optimal deployment of existing nursing and health visitor resources for the purposes of reducing HAI, (paragraph 102).
9. Clinical audit should be an integral part of the proposed national framework for HAI surveillance in Scotland, (paragraph 108).
10. The SCIEH Electronic Transmission Project Board should take forward the development of a minimum core dataset to streamline the capture and exchange of HAI surveillance data from laboratories to Health Boards and SCIEH using the NHSnet, (paragraph 110).
11. The Project Board should also begin to examine the feasibility of linking HAI surveillance data collection to antimicrobial resistance patterns and prescribing data in Trusts and the Community, as recommended in the House of Lords Select Committee report and reinforced at the recent EU Conference, (paragraph 113).
12. The Management Executive should give serious consideration to the funding of any business case(s) submitted by SCIEH as a result of the above recommendations, (paragraph 114).
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