3.1 Background
3.1.1 The need for a review of decontamination processes in neurosurgery and posterior ophthalmic procedures, ahead of considering the results of the Main Review, followed a SEAC decision that such procedures carry the highest potential risk of patient to patient transfer of vCJD from contaminated surgical instruments.
3.1.2 The term ‘fast track’ refers to the way in which the review group’s recommendations for investment, to address the deficiencies found, were processed by the Health Department’s Capital Investment Group (CIG). It allowed the plans to be considered ahead of any required business case submissions, which are required under the Department’s normal capital investment approval procedures.
3.1.3 Ten sites, managed by seven trusts, provide decontamination services for the surgical procedures in question. The trusts concerned were:
3.1.4 The objectives of the Fast Track Review were to:
3.2 Review Methodology
3.2.1 All ten sites were visited by representatives of the assessment teams used in the earlier Old Group review (see 1.2.1 to 1.2.3 above). The criteria by which the sites were assessed are summarised at Appendix E.
3.2.2 The review revealed that only one trust (Ayrshire & Arran Acute) met the required standards. Accordingly, the other six were requested to produce costed action plans for bringing their processes up to the required standards, and to present their cases to a sub-group of the Glennie Group to assess the appropriateness and cost accuracy/effectiveness of the proposals.
3.3 Sub-group’s Recommendations
3.3.1 The plans contained a range of proposals. They went from the provision of additional re-usable surgical instruments, to cover the extended turn round time that will result from ending LDU processes, to the procurement of new washer/disinfector equipment and minor building works, to ensure the adequate separation of clean and dirty processes.
3.3.2 The Group made recommendations to the Scottish Executive Health Department in respect of each trust. The Department accepted the recommendations overall and have separately pursued the cost and implementation issues in each case.