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The Scotland Performs website brings together many different results from dozens of sources, all of which have differing requirements in terms of processing, quality assurance and publication. The data on Scotland Performs is at any time the most up-to-date there is available. Though some gaps and time lags have been unavoidable due to the move to focus on outcomes and the need to identify new performance measures to best support that, the position is improving all the time. In the past six months alone, 24 updates have been made to the website, some of them making data available for the very first time.

The data on Scotland Performs is produced under Official Statistics Standards, which are set out in the Code of Practice for Official Statistics. This requires that data is published as soon as is practicably possible, whilst assuring the high standards of quality of Official Statistics. Statisticians within government are always striving to minimise data lag and, where these cannot be reduced further, to consider provisional or proxy sources to help give earlier information.

Health Protection Scotland (HPS) are providing on-going expert advice to the NHS Grampian Outbreak Control Team to support the management of the current outbreak at Dr Gray''s Hospital, Elgin.

NHS Quality Improvement Scotland (NHS QIS) have also undertaken a review of the infection prevention and control processes in place at Dr Grays. This function is consistent with the NHS QIS remit of providing advice and guidance on effective clinical practice, including setting standards, and to drive and support implementation of improvements in quality across NHS Scotland.

Their report will be published on the NHS QIS website by the end of June 2009. I will ensure that any lessons needing to be learned are applied to NHS Grampian as well as to NHS Scotland as a whole.

I am advised by NHS Grampian that on 30 April 2009 the Infection Control Team at Dr Gray''s Hospital identified a higher than expected number of Clostridium difficile cases recorded over the course of that month. The Scottish Government was notified on the same day.

NHS Grampian has determined the start of the outbreak in Dr Gray''s Hospital as 1 April 2009. The first case identified thereafter was on 6 April 2009. However, in line with Health Protection Scotland (HPS) guidance, a look back exercise of all Clostridium difficile cases up to 12 weeks prior to 1 April 2009 is now underway. This will confirm when the first case linked to the current incident occurred.

A full Outbreak Control Report will be available once all investigations are complete.

The information requested is not held centrally as data on cleaning staff employed by NHS are not captured separately in the workforce statistics. Data is available for the hotel services/domestic staffing group which encompasses staff employed to clean. The following table shows head count and whole time equivalent domestic staff in post at 30 September 2008 who are directly employed by NHS Greater Glasgow and Clyde. Information at hospital level is not available centrally. Information is not available for staff who are employed by external contractors.

Domestic Staff¹ Employed by NHS Greater Glasgow and Clyde

Post description	Head Count	Whole-Time Equivalent (WTE)
Domestic Assistant	1,472	848.8
Domestic Assistant Higher Level	605	382.5
Domestic Supervisor	145	117.7
Domestic Supervisor Higher Level	1	1.0
Total	2,223	1,349.9

Source: Scottish Workforce Information Standard System (SWISS) Data as at 30 September 2008.

Note: 1. Following assimilation to Agenda for Change pay bands, domestic staff are identified by the post-descriptors shown in the table above. Any domestic staff that have assimilated to other post descriptors will not be counted as they cannot be readily identified. The job profiles for domestic staff also include other tasks and due to this the above table includes domestic staff employed to do tasks other than cleaning.

NHS boards have been asked to ensure that records be maintained of how the additional resources announced for hospital cleaners is being used. The first return is due at the end of May 2009.

Guidance for the production of single outcome agreements and annual reporting by Community Planning Partners has been produced jointly by the Scottish Government, COSLA, the Society of Local Authority Chief Executives, the Improvement Service and Audit Scotland. There is no obligation upon Community Planning Partners to set out how they, or individual partners (such as councils), are implementing statutory obligations such as those under the 2003 act, in single outcome agreements or related annual reports.

The Scottish Government has published additional guidance called With Inclusion in Mind. This sets out practical action that local authorities can take in respect of the new duties outlined in Sections 25 to 31 of the Mental Health (Care and Treatment) (Scotland) Act 2003. The Scottish Government continues to work with local authorities to support implementation. The new duties are also reflected in the Scottish Recovery Indicator which has been developed to assess the degree to which services address rights, social inclusion and recovery and which the Scottish Recovery Network is working with service providers, including local authorities, to implement.

I am advised by NHS Grampian that of the 13 isolates sent to the National Reference Laboratory for typing, eight have been typed as 027; two are 001 cases, one is an 026 case and one other is an 023 case. NHS Grampian is awaiting the results of the one remaining sample.

NHS Grampian has advised that its antimicrobial prescribing policy was first adopted in 2004 and was last reviewed in March 2009. Adoption and implementation of the revised policy began in March 2009. Implementation is the responsibility of managers at all levels of the organisation. Implementation of NHS Grampian''s revised policy is the subject of on-going audit which is being undertaken in line with guidelines published by the Scottish Antimicrobial Prescribing Group (SAPG).

National guidance requires the setting of local trigger thresholds for each clinical area. I am advised by NHS Grampian that an investigation is triggered when two or more cases occur in the same ward area and that this trigger was applied in the recent outbreak at Dr Gray''s Hospital.

Since publication of With Inclusion in Mind, the Scottish Government has provided additional funding to local authorities in 2007-08 and in 2008-09 to support them in developing responses to the guidance. A conference was held in the autumn of 2008 to share best practice and further encourage and support this work. The funding support and conference will be repeated in 2009-10.

Local authorities have a duty to meet the statutory requirements of the Mental Health (Care and Treatment) (Scotland) Act 2003 but may do so in a variety of ways.

Eligibility criteria may refer to the allocation of some resources but would never exclude access to resources such as assessment, advice and guidance. Responses to Section 26 will often include these as well as support to access other main stream services.