On 14^th October 2008 Health Minister, Michael McGimpsey announced his intention to hold a public inquiry into the C diff outbreak in the Northern Health and Social Care Trust after receiving the final report from the Regulation and Quality Improvement Authority (RQIA), who investigated an outbreak of C diff at Antrim, Braid Valley, Mid Ulster, Moyle and Whiteabbey hospitals between 16 June 2007 and 31 August 2008.

The RQAI review of the outbreak provided 17 recommendations in addition to the 36 recommendations it made in an earlier report and the implementation of all of these commenced immediately. However two important issues remained unanswered; firstly, how many people died as a result of the outbreak and, secondly what were the experiences of patients and others who were directly affected by the outbreak. The Minister determined that a Public inquiry addressing these issues was necessary in order to restore public confidence in the safety and quality of healthcare.

View the full RQIA report.

The issues the Inquiry has been asked to address are firstly, to establish how many deaths occurred in Northern Health and Social Care Trust hospitals during the outbreak, for which C diff was the underlying cause of death, or was a condition contributing to death and, secondly what were the experiences of patients and others who were directly affected by the outbreak of C diff infection that occurred in Northern Health and Social Care Trust hospitals between 16 June 2007 and 31 August 2008

During this time the C diff infection levels were identified as an “outbreak” as the levels of infection had exceeded the normal baseline rates.

Dame Deidre Hine, the former Chief Medical Officer for Wales and Chair of the Commission for Health Improvement, is the Chairman of the Inquiry. The other Panel members are: Dr Jocelyn Cornwell, an independent healthcare consultant and director of The Point of Care Programme, King’s Fund; Mrs Eleanor Hayes, independent healthcare consultant and former Director of Nursing and Governance at Belfast City Hospital Trust and Green Park Hospitals Trust; and Professor Robert Stout, formerly Professor of Geriatric Medicine at Queen’s University Belfast.

The Health Minister, Michael McGimpsey appointed the Inquiry Panel on March 31^st 2009.

The Panel has legal advisors including a solicitor and a senior barrister, and access to experts from Great Britain to provide advice on determining the exact numbers of deaths which resulted from the outbreak. The Panel has also been provided with the following documentation of the outbreak to inform its investigation:

No, the Inquiry is limited to the Hospitals involved during the outbreak, which took place between 16 June 2007 and 31 August 2008. These were Antrim, Braid Valley, Mid Ulster, Moyle and Whiteabbey. At the time the C diff infection levels were identified as an “outbreak” as the levels of infection in these hospitals had exceeded the normal baseline rates.

Publicising the work of the Inquiry and the methods of engaging with the Panel. This involved media relations across all regional and local print and broadcast outlets; publicity in staff newsletters; circulation of information letters and  questionnaires to GP’s in the affected area; letters of invitation sent directly to patients and the relatives patients identified as being directly affected and through letters to staff across the Trust.  In addition the Patient Client Council assisted in promoting the Panel’s work through distribution of leaflets. One hundred and fifty people responded to these efforts.

The panel has held a series of meetings with patients, relatives of patients and staff, directly affected by the outbreak of C diff in the Northern Trust at eight venues across the Trust area with over 140 people participating in these meetings. The information gathered at these meetings will allow the Inquiry team to identify those areas that require close scrutiny by the Panel.

The Inquiry will be moving to this stage which involves the taking of formal written evidence by the Inquiry Panel’s solicitor in the New Year. Guidance on the support available for this will be provided to those from whom the Inquiry wishes to receive formal evidence.

It may be necessary to receive oral evidence formally from witnesses. The extent to which the public shall be admitted to such hearings will depend on the subject matter. Where possible, confidentiality of families, patients and staff will be respected by the Inquiry Panel.

The Inquiry will begin the process of taking formal evidence in early 2010.

The Inquiry team intends to put records of the oral hearings on the website www.cdiffInquiry.org.

The Panel intends to publish the key evidence with its report at the end of the Inquiry. It may also publish material on the website as the Inquiry progresses where this will help increase public understanding of its work.

13. Can the public attend the Oral hearings?

Members of the public and the media can attend the oral hearings to which the public are admitted. Those attending will be asked to follow certain standards of behaviour, similar to those in a courtroom, although this is not a judicial Inquiry. A leaflet will be given to anyone entering the hearing centre outlining these standards.

14. Who will the Inquiry call to give evidence?

Having considered the issues and material which it has requested or has been drawn to its attention, the Committee will invite those it judges as best placed to supply the evidence it needs to conduct its task thoroughly.

15. Why would someone need to give evidence in private?

The Protocols set out that the Inquiry will hear all oral evidence in public unless the Panel judges it should be heard in private. The factors the Panel will take into account in considering whether evidence should be given in private include genuine reasons such as the health of the person and if that would make it difficult for them to appear.

16. What protection do witnesses have to speak freely?

The Panel expects all witnesses to provide truthful,fair and accurateevidence. The Inquiry welcomes the fact that the Trust has provided staff with reassurance that they will not be penalised in any way as a result of participation in the Inquiry process.

You can submit your information to the Inquiry electronically using the questionnaire form on the website. Alternatively, if you prefer, you can write to us at :

C diff Public Inquiry
Premier Business Centre
20 Adelaide Street
Belfast
BT2 8GB

or by calling Kate McClements on 028 90 517124 or Email: Inquiry@cdiffInquiry.org

18. Does the Inquiry have a Freedom of Information policy?

The Inquiry, itself, is not a public authority for the purposes of the Freedom of Information Act, so the Act does not apply. However, in addition to its hearings being open to the public and the media wherever possible, the Inquiry's website will contain transcripts of public hearings and other key information relating to the work of the Inquiry.

19. When and how will the report be published?

The Committee intends to complete its task as quickly as possible. The Health Minister Michael McGimpsey said at the launch of the Inquiry in March 2009 that the Inquiry would report within12 months. Given the significant levels of participation by the public the process is likely to take until June 2009.

20. Will there be an interim report?

No. The report will be a single one at the end of the Panel’s deliberations.

21. How much will the Inquiry cost/how much is the budget?

The Panel is determined to ensure that it runs the Inquiry efficiently and does not waste public money. The Inquiry will publish its costs.

Dame Deirdre Hine will include recommendations in her report that arise out of the work of the Inquiry.  The publication of the final report will be a matter for the Minister of Health, Social Services and Public Safety.