COVID-19 Nosocomial Review Group

Overview

Context

The Chief Nursing Officer (CNO) and Chief Medical Officer (CMO), in consultation with the HCAI/AMR Policy Unit and the National ARHAI service within NHS National Services Scotland (NSS), identified the need for additional analysis of nosocomial (hospital associated and onset) transmission of COVID-19 in Scotland.

The Scottish Government COVID-19 Nosocomial Review Group was a time limited expert group chaired by Professor Jacqui Reilly, Nurse Director and Healthcare Associated Infection (HCAI) Executive Lead at NSS.

The advisory group considered the scientific, technical concepts and processes that were key to understanding the evolving COVID-19 situation and potential impacts in hospitals in Scotland.  The advisory group applied the advice coming from the World Health Organisation (WHO), the Scientific Advisory Group on Emergencies (SAGE), the UK-wide Infection Prevention and Control (IPC) guidance cell and other appropriate sources of evidence and information and used it to inform the decision-making process in Scotland during the pandemic.

The group was accountable to the Scottish Government, through the Chief Nursing Officer (CNO), and provided the CNO with advice.  Thereafter, the CNO and the HCAI/AMR Policy Unit considered the advice and used it to inform policy development. The CNO and HCAI/AMR Policy Unit also considered any cross cutting policy impacts and consult with the CMO, National Clinical Director other Health and Social Care Directors where necessary. 

The CNRG also reported into the Chief Medical Officer’s Scientific Advisory Group (CMO AG) to ensure two-way information and evidence sharing within Scotland and also with wider UK groups, such as the NHSE/I Healthcare Onset COVID-19 Infection (HOCI) Group and the UK IPC guidance cell.  This enabled Ministerial updates to the Cabinet Secretary for Health and Sport, the First Minister and other portfolio interests.

Remit

The group supported Scottish Ministers and senior clinical advisers to:

• interpret SAGE outputs and other emerging scientific evidence in relation to nosocomial infection in the context of Scotland.
• provide expert advice spanning the disciplines of infection prevention and control, clinical advice, nosocomial infection, clinical advice, epidemiology, virology and statistical modelling.
• make recommendations to CNO and CMO to reduce and mitigate against COVID-19 nosocomial infection, including but not limited to the following subject areas: national surveillance, testing, screening, research, guidance and policy.
• support the Scottish Government COVID-19 Corporate Analytical Hub, overseen by the Chief Statistician, through analysis of nosocomial infection data in Scotland.
• advise the Scottish Government, SGHSC Directorates, and COVID-19 Corporate Analytical Hub on strategic approach to identifying, accessing and using data to support our understanding and response to nosocomial transmission of COVID-19 in Scotland.
• develop links with other SG COVID-19 Advisory Groups; including co-opting members to the group as appropriate and taking early decisions on whether any supporting groups should be established.
• maintain close engagement with SAGE and their nosocomial sub-group, as well as the UK-wide Infection Prevention and Control (IPC) guidance cells.
• act as a mechanism for approving COVID-19 related ARHAI guidance.
• the focus of this group was on nosocomial (hospital associated) infection and transmission, however it maintained close engagement with colleagues in the Scottish Government, National ARHAI Scotland and Public Health Scotland to ensure findings are shared and that policy recommendations are developed with system considerations and collaboratively.

The recommendations from the COVID-19 Nosocomial Review Group in Scotland were largely taken forward by National ARHAI Scotland within NSS. The HCAI/AMR Policy Unit within the Scottish Government worked closely with the group to progress policy development and implementation, as well as providing secretariat support.

‎The existing identified evidence gaps and the recommendations are outlined in the Terms of Reference.

Members

Members are infection prevention and control experts, clinicians and academics spanning the disciplines of epidemiology, virology, public health and statistical modelling.

• Professor Jacqui Reilly, NHS National Service Scotland (NSS) and Glasgow Caledonian University (Chair)
• Associate Chief Nursing Officer for HAI, SG
• Laura Imrie, Lead consultant for National ARHAI service, NSS
• Professor Tom Evans, University of Glasgow and Consultant in Infectious Disease and General Medicine
• Dr Colin Ramsay/Dr Maria Rossi, Public Health Scotland
• Professor Matt Holden, University of St. Andrews
• Professor Chris Robertson, University of Strathclyde and NSS
• Professor Stephen Reicher, University of St. Andrews
• Professor Hazel Borland, Nurse Director and SEND
• Dr Andrew Seaton, Scottish Antimicrobial Prescribing Group (SAPG)
• Sofie French, Principal Educator (ARHAI) at NHS Education for Scotland
• Sandra Devine, Infection Control Managers’ Forum
• Dr Aleks Marek, Chair, Infection Control Doctors
• Pamela Joannidis, Chair, Infection Control Nurses
• Dr Graham Foster, Chair, Scottish Directors of Public Health Group (SDsPH)
• Kate Templeton, Consultant Clinical Scientist, NHS Lothian
• Dr Martin Connor, Consultant Microbiologist, Clinical Lead SMVN
• National Clinical Lead for Quality and Safety, SG
• Dr Alastair Leckie, Consultant in Occupational Medicine, Director NHS Lothian Occupational Health and Safety Service
• Interim Deputy Chief Medical Officer and/or Senior Medical Officer, Chief Medical Officer Directorate
• Professional Advisors, Chief Nursing Officer Directorate
• Susan Grant, Principal Architect, NHS Health Facilities Scotland
• Shona Cairns, Lead Healthcare Scientist/Epidemiologist, National ARHAI Service
• Emma Hooker, Principal Healthcare Scientist, National ARHAI Service

Membership will be kept under review.

Minutes

Published muinutes are available at: COVID-19 Nosocomial Review Group: minutes

Documents

• COVID-19 Nosocomial Review Group: terms of reference