Standards of cleanliness at The Western General Hospital have been severely criticized in a report (see below) by official watchdog The Healthcare Environment Inspectorate (HEI). NHS Lothian chiefs have said they have already acted to respond to concerns.
Chief Inspector Susan Brimelow said: “We carried out an unannounced inspection to the Western General Hospital on Tuesday 18 and Wednesday 19 November 2014. Due to significant concerns about the cleanliness of patient equipment and the environment, we escalated our findings to senior management in the hospital.
“We requested that NHS Lothian take immediate action to address these issues and produce an improvement action plan. We returned unannounced on Thursday 27 November 2014 to assess progress against the improvement action plan and found that significant improvements had been made. NHS Lothian must address the requirements and make the necessary improvements as a matter of priority.”
In a full statement issued earlier today the HEI said:
We previously inspected the Western General Hospital in February 2013. That inspection resulted in four requirements and five recommendations. The inspection report is available on the Healthcare Improvement Scotland website.
We carried out an unannounced inspection to the Western General Hospital on Tuesday 18 and Wednesday 19 November 2014. Due to significant concerns about the cleanliness of patient equipment and environmental cleanliness within the Western General Hospital, we escalated our concerns to senior management in NHS Lothian on 18 November and then again on 19 November 2014. On ward 52/53, we also raised concerns about the lack of working macerators and the procedures in place to reduce the risk of cross-infection to patients, staff and visitors. Macerators break human waste down into slurry so it can be sluiced effectively. We requested that immediate action be taken on these issues and an improvement action plan produced to show how these issues would be rectified.
We returned unannounced on Thursday 27 November 2014 to assess progress against the improvement action plan at ward and departmental level. Significant improvements had been made although we still noted some issues with the cleanliness of patient equipment and the environment.
We assessed the hospital against the NHS Quality Improvement Scotland (NHS QIS) healthcare associated infection (HAI) standards and inspected the following areas:
- ward 2 (oncology)
- ward 4 (oncology)
- ward 15 (winter ward)
- ward 20 (ICU)
- ward 26 (general medicine)
- ward 27 (colorectal)
- ward 43 (regional infectious diseases unit)
- ward 50 (stroke unit), and
- ward 52/53 (gastroenterology).
Overall, we found evidence that NHS Lothian is not complying with the NHS QIS HAI standards to protect patients, staff and visitors from the risk of acquiring and infection.
In particular we found:
- the standard of cleanliness of the patient environment was poor
- the standard of cleanliness of patient equipment was poor, and
- a lack of appropriate risk assessments, for example for out-of-order macerators.
The report highlights areas of strength and weakness as well as areas for further improvement, including requirements and recommendations.
This inspection resulted in eight requirements and one recommendation.
NHS Lothian must address the requirements and make the necessary improvements within the stated timescales.
Responding to the report, Melanie Johnson, executive nurse director at NHS Lothian, said staff had acted on the inspectors’ findings as ‘a matter of urgency’.
Ms Johnson said: “We recognise that some standards were below those we would expect and I apologise to any patients who may have been affected. I would also like to reassure them that those areas have been rectified – since the first of the visits in November, immediate changes were put in place to address all areas that were singled out for improvement.
“A detailed action plan was drawn up and all points have been completed. Many of these significant improvements were proven during the subsequent unannounced visit by inspectors as is detailed in the report.”
Commenting on the ‘extremely disappointing’ findings, Health Secretary Shona Robison said: “The report shows that standards have fallen well short of what the public and patients expect. The inspectors have uncovered simply unacceptable levels of cleanliness and infection control in certain wards, and I will be meeting the chair of NHS Lothian to reiterate my desire to see standards immediately improve. The improvement plan in place must be delivered urgently.”
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