Health Secretary Shona Robison has ordered an independent review into concerns around A&E waiting times practices and staff pressure at St John’s Hospital.
Ms Robison was first alerted to claims of non-compliance with recording practices in October when she was contacted by a whistle-blower. She immediately responded and instructed NHS Lothian to carry out a full investigation, which was underway within two days.
Following interim findings which confirmed areas of concern, the Cabinet Secretary has asked the Scottish Academy of Medical Royal Colleges, Chaired by Professor Derek Bell, to undertake an external review to investigate the full circumstances.
The review will report back to the Cabinet Secretary early in the new year.
Ms Robison said: “These are serious allegations and the early findings are clearly a cause for concern. That is why I have asked Professor Bell to lead an independent review of these allegations.
“We are working very closely with the Board to ensure that lessons are learned from the investigation and recommendations made are fully implemented as soon as possible and shared across NHS Scotland.”
Jim Crombie, Deputy Chief Executive, NHS Lothian, said: “NHS Lothian is committed to the values of openness and transparency and we have placed them at the heart of our organisation. We actively encourage our staff in NHS Lothian to highlight issues relating to patient safety and we take any allegations of misconduct or wrongdoing very seriously.
“We have a robust Whistleblowing Policy in place to ensure that all our staff are supported and feel able to raise any concerns and I am encouraged that staff are able to discuss them.
“As soon as we received these concerns, an internal audit team was appointed, headed by a senior non-executive director to oversee the investigation and get to the bottom of the concerns.
“We will cooperate with and support the work being carried out by the external review team.”
Early findings from the internal review show that staff in St John’s Hospital have been applying locally produced guidelines on how to record patients who breach the four hour access standard which do not comply with national guidance.
The initial draft report also found that no evidence of bullying or harassment was found during interviews with staff and that busy staff had produced their own reference guides for inputting information into the data recording system. However, the report stressed that the guidance sheets were only “created with the best intentions of clarifying arrangements.”
The report said: “Local procedures were drafted with the best of intentions of clarifying to staff when a patient has or has not breached the four-hour access target.”
It meant that some patients who may have been recorded as breaching the waiting time performance target, were not included in departmental performance reports.
The report will be shared at the next public board meeting of NHS Lothian on December 6th.
It is then expected that the external review team will report back to the Cabinet Secretary early next year and the report will be submitted for discussion at the following public board meeting on NHS Lothian in February.
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