Hospital Onset COVID-19 Cases in Scotland

Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) Scotland, part of National Services Scotland works closely with Public Health Scotland to deliver the COVID-19 response. This dataset provides data for COVID-19 hospital onset cases in Scotland for week ending 1 March 2020 onwards, as available.

COVID-19 cases first diagnosed within hospital in-patients are classed as hospital onset COVID-19, with the length of time between admission and their first COVID-19 positive sample determining their hospital onset status. ARHAI Scotland is working with NHS boards on a continuous basis to validate COVID-19 hospital onset cases to ensure the data are robust. Data are published on the Open Data platform at NHS Scotland level, by week of specimen date.

All publications and supporting material to this topic area can be found in the weekly Hospital onset COVID-19 cases in Scotland publication. Further information on the epidemiology of COVID-19 in healthcare settings can be found on the Public Health Scotland website. The date of the next release can be found on our list of forthcoming publications.

Data and Resources

Additional Info

Field Value
Source COVID-19 case data are sourced from Corporate Data Warehouse (CDW) that contains test results from Electronic Communication of Surveillance in Scotland (ECOSS). Cases are subsequently linked with RAPID (Rapid Admission Preliminary Inpatient Data) to determine provisional admissions data, and subsequently validated by local Infection Control Teams within NHS Boards, to determine hospital onset status for all COVID-19 patients.
Author ARHAI Scotland
Last Updated November 26, 2021, 14:08 (GMT)
Created December 3, 2020, 11:07 (GMT)
Contact Address ARHAI Scotland, NHS National Services Scotland, Meridian Court, 5 Cadogan Street, Glasgow, G2 6QE
Subject COVID-19, Hospital Onset
Frequency Weekly
Time frame of data and timeliness Data are published 3 to 4 weeks in arrears.
Coverage Data covers all COVID-19 episodes since the start of the pandemic in March 2020 for the whole of Scotland.
Completeness Hospital onset cases of COVID-19 refer to all instances of COVID-19 first diagnosed within existing hospital in-patients. Any COVID-19 cases who were first tested in the community, but who may have gone on to require hospital case, are coded as community onset. In addition to validating COVID-19 case and admissions data compiled by CDW and RAPID, NHS boards are able to supplement additional records which may not have been captured through these sources. This therefore means that completeness for hospital onset cases under current definitions is near to 100%.
Accuracy It is acknowledged that patients can be transferred between NHS health boards and if transferred into a different health board during the same hospital stay, then the clock is restarted to ‘day 1’ which could lead to an underestimation of cases. However, the decision to restrict start date to admission to a single NHS health board represents the requirement to report at the health board-level. Any discharges and re-admissions which occur within the same calendar day will be overlooked - the clock will not be restarted in these instances, only when a readmission occurs on the second or more day after any discharge. COVID-19 cases identified after discharge from hospital but within 14 days may be associated with the hospital. These cases, including those identified on readmission to hospital, are not included as hospital onset. This may result in under-reporting of COVID-19 cases associated with hospital care.
Continuity of data No major changes since this surveillance was launched. For minor changes in methodology please see the Hospital Onset COVID-19 Cases in Scotland publication for full details.
Concepts and definitions The transmission of COVID-19 is thought to occur mainly through respiratory droplets and through contact with contaminated surfaces. Further information on the epidemiology of COVID-19 in healthcare settings can be found on the Public Health Scotland website. website. As sustained community transmission has occurred as the pandemic has progressed, it has become more challenging to identify true cases of hospital transmission. A system for monitoring COVID-19 is critical to tracking nosocomial transmission in healthcare settings to inform infection, prevention and control measures. In response to the Scottish Government’s request to ascertain and validate the hospital-onset status of all COVID-19 cases in Scotland, ARHAI Scotland are working with NHS boards to establish a minimum viable dataset to fulfil this request. The agreed nosocomial case definition for the UK is based on the number of days since admission to an NHS health board to the date of specimen sampling for a positive SARS-CoV-2 RT-PCR test. Time since admission to specimen sampling is categorised as: • community onset (first positive specimen taken in the community) • non-hospital onset (first positive specimen on day 1 or 2 of admission to NHS board) • indeterminate (first positive specimen on days 3 to 7 of admission to NHS board) • probable (first positive specimen on days 8 to 14 of admission to NHS board) • definite hospital onset (first positive specimen date was 15 or more days after admission to NHS board) Hospital onset cases represent cases presenting in hospital and do not include COVID-19 associated with hospital care that present on readmission to hospital or post-discharge. Non-Scottish cases where their first positive was taken within a Scottish hospital are included in the hospital onset counts, but are excluded from community counts. Admission to health board was agreed as the appropriate point to start counting the duration of hospital stay to first positive specimen date, rather than the date of admission to a single hospital, since patients can be transferred between hospitals which would lead to restarting the clock to ‘day 1’ each time and therefore underestimating the number of nosocomial infections. Any discharges and re-admissions which occur within the same calendar day will be classed as a continuous stay; the clock will not be restarted in these instances, only when a readmission occurs on the second day or more after any discharge.
Disclosure The PHS protocol on Statistical Disclosure Control Protocol is followed.
Revision statement These data are not subject to planned major revisions.
Official statistics designation Management Information
Format csv
Language English

Hospital Onset COVID-19 Cases in Scotland publication

HPS website - Coronavirus (COVID-19)

HPS website - Epidemiology of COVID-19

comments powered by Disqus