Tag: NHS Lothian

‘Absolutely staggering’: spreadsheet error led to delays in hospital opening

A mistake in a spreadsheet calculation set in motion a series of events that led to the delayed opening of the new £150m Sick Kids hospital, a new report has revealed.

Health Minister Jeane Freeman stepped in when last-minute issues with ventilation prevented the opening of Edinburgh’s new children’s hospital last July.

The go-ahead for a new hospital at Little France, a replacement for the ageing Sick Childrens Hospital in Sciennes, was first agreed by NHS Lothian in 2005 but the project has seen a catalogue of delays and spiralling costs.

Scottish Conservative health spokesman, Lothian MSP Miles Briggs, said: ““It is absolutely staggering that this mistake has had such huge repercussions and was not picked up until after the new hospital had been built.

“This review is highlighting how ill equipped health boards are for undertaking projects the magnitude of a new hospital.

“SNP Ministers are ultimately responsible for what has been described as a ‘collective failure’ in the specifications of ventilators at the hospital.

“This fiasco has cost the tax payer enormous amounts of money, money which should have gone towards properly resourcing hospitals and improving treatment times.”

Round the clock children’s services to return at St. John’s

Round the clock paediatric inpatient services in St John’s Hospital will resume this Autumn, NHS Lothian announced yesterday.

The service will be reinstated 24 hours a day, seven days a week, from October, to enhance the care already provided to children in West Lothian.

The details were agreed by NHS Lothian board members at their meeting yesterday (Wednesday August 12).

It means that inpatient paediatrics will be extended from functioning four nights a week, to seven days and nights by October 19.

Dr Tracey Gillies, Medical Director, NHS Lothian, said the children’s ward was now in a position to fully re-open after a number of new staff were recruited to the team.

Dr Gillies said: “We are really pleased that we are able to fully reinstate children’s inpatient services 24/7 in St John’s Hospital. It is testament to the teams who have pulled together to make this happen.

“We have always said that we could only restore the full service when it was safe and sustainable to do so and that has been our priority throughout.

“Parents and children will not have to do anything differently and many may not even notice a difference. However it does mean that patients who require to remain in hospital over a weekend will be able to do so at St John’s, instead of routinely being transferred to the Royal Hospital for Sick Children in Edinburgh.”

Two permanent Consultants and one locum have been recruited to the team at St John’s, following successful rounds of recruitment in June. A small number of ward nurse vacancies are in the process of being filled, meaning that staffing in the unit will be further strengthened.

The availability of Advanced Paediatric Nurse Practitioners has also increased, giving added resilience to the staffing rota.

The Paediatric Programme Board (PPB), which was established to help develop and implement a strategy to deliver safe and sustainable services, was told at its most recent meeting that the unit had sufficient cover to provide a safe and sustainable rota for out of hours and weekend shifts.

It was also agreed that the programme board will now be dissolved because it has fulfilled its remit.

It comes just weeks after the Royal College of Paediatrics and Child Health published its most recent review into the service and praised NHS Lothian for its “considerable and impressive efforts” to restore the 24/7 service.

NHS Lothian invited the RCPCH to return and undertake a second follow up review of progress since their original Review and Report in 2016. The visit took place in February 2020 and the College’s Report was received at the end of May 2020.

Parents and families are not required to do anything differently as a result of the change and will still access care in the normal way, through NHS 24, their GP or the Emergency Department.

If children are very sick or require specialist intervention, they will continue to be admitted to the Royal Hospital for Sick Children, in line with the normal protocols.

Scots encouraged to follow crucial steps to control coronavirus

The role NHS Scotland Test and Protect plays in containing future coronavirus outbreaks has been highlighted, as new research suggests people know their actions count.

With the vast majority (89 per cent) of people believing it necessary to follow the Scottish Government’s guidelines if the country is to get out of lockdown, NHS Lothian has reminded people of three things they need to do to help suppress the virus as restrictions ease:

1:  Self-isolate and book a test immediately if you have coronavirus symptoms: a new, persistent cough, high temperature or loss or change in taste or smell.

2:  If the test result is positive, you’ll be contacted by a member of the NHS team and asked to provide them with the names of people you’ve been in close contact with as they may be at risk.

3:  If you’re contacted by NHS Scotland to say you’ve been in close contact with someone that has the virus, isolate for 14 days.  Following this advice is crucial as it can take 14 days for symptoms to develop, and the virus can be passed on during this time.

The research, released as the nation moves through phase 3 of the route map, shows that the majority of people in Scotland (92 per cent) see the role individuals have in suppressing coronavirus as important.

However, with one in ten (12 per cent) saying they are less likely to follow guidelines if others aren’t following them, NHS Lothian yesterday encouraged people to stick with it over the coming weeks and months to protect themselves, their loved ones and keep their community safe.

Professor Alison McCallum, Director of Public Health, NHS Lothian said: “Test and Protect is key to breaking the chains of coronavirus transmission, protecting the progress we’ve made and helping to save lives. 

“If you have symptoms, please self-isolate, get tested and share details of those you’ve come into close contact with.  If you have been in close contact with someone who has tested positive and are asked to self-isolate by the NHS, it’s essential you follow that advice.  Support to self-isolate is there if you need it.

“For this to work, we need everyone’s help. If you have symptoms, we’re asking you to self-isolate, get tested and share details of those you’ve come into close contact with. If you have been in close contact with someone who has tested positive and are asked to self-isolate by the NHS, it’s important to follow that advice. 

“These three steps, along with following the FACTS guidelines, shows people you care about others, sets a good example, will help keep the virus under control and will allow us to continue to emerge from lockdown.”

People can book a test at nhsinform.scot/test-and-protect or call 0800 028 2816 if they can’t get online.

The website provides information on additional support available. If you need to self-isolate and can’t get the help you need from family, friends or online, you can call the National Assistance Helpline on 0800 111 4000. Local help is there for you behind that national number.

To reduce the risk of catching or spreading coronavirus, or being asked to isolate, remember FACTS – Face coverings, Avoid crowded places, Clean hands and surfaces regularly, Two-metre physical distancing and Self-isolate and book a test immediately if you have coronavirus symptoms.

Cancer clinical trials back on track

Throughout the COVID-19 pandemic, patients across Lothian and the south-east of Scotland have continued to receive cancer treatment through a range of clinical trials.

Recently, with pandemic restrictions easing, more patients have resumed participation in cancer trials. And today (29 July) teams in the South East Scottish Cancer Research Network (SESCRN) are pleased to announce that any remaining trials that have been on hold in the region are all now able to reopen and would like to reassure patients that all trial options will be available to them.

The SESCRN teams – based in the Edinburgh Cancer Centre at the Western General Hospital – are also recruiting patients to take part in a series of new clinical trials.

Stefan Symeonides, a Consultant Oncologist and Clinical Lead for SESCRN, said: “COVID-19 presented us with significant challenges – and still does – but our teams have worked hard to minimise disruption caused by the pandemic.

“We’ve had to adapt how trials are delivered to patients, implementing a range of infection prevention and control measures required as a result of COVID-19, including social distancing. This enabled all patients already started on clinical trials for cancer treatment to remain on those trials.”

However, COVID-19 has restricted access to clinical trials for other patients who would have started treatment during the peak of the COVID-19 challenges.

“We share the concern and frustration experienced by these patients, which is why we are pleased that the recent easing of pandemic restrictions has allowed us to open trials back up again and widen patient access to other trials,” said Stefan Symeonides. “We are now able to reopen all remaining studies and we are excited to have started recruiting patients to new clinical trials.”

Dot Boyle, Network Manager with SESCRN, said: “Colleagues across the Network have made monumental efforts to continue clinical trials.

“For example, we were able to keep some trials running, where there were no safety concerns for patients and, since June, a range of other trials have resumed. We are currently engaged in over 100 clinical trials, half of which are open, with the other half now due to open imminently.

“In addition, every day, our teams work in collaboration with a range of partners to help facilitate more and more new trials, the first of which have opened, covering a range of different areas, including cancer of the bladder, breast and kidney.”

Professor Charlie Gourley, Professor and Honorary Consultant in Medical Oncology, Western General Hospital, said: “Clinical trials offer cancer patients new opportunities, either in addition to standard treatments, or after standard therapies have failed.

“They provide patients with hope and are a vital part of our armoury. The South East Scotland Cancer Research Network is rapidly reinstating these studies in order to offer our patients the best possible treatment options.”

Health support from NHS Lothian

The most recent Diet, Physical Activity and Healthy Weight key messages to support the public during the COVID-19 restrictions:

Physical Activity: http://www.paha.org.uk/Feature/covid-19-physical-activity-key-messages

Diet and Healthy Weight: http://www.paha.org.uk/Feature/covid-19-diet-and-healthy-weight-key-messages

Please feel free to share through your networks.

John Brennan | Senior Health Promotion Specialist (Physical Activity) | NHS Lothian Health Promotion Service

Children’s Outpatients’ services prepare for move to their new home

NHS Lothian staff working across a number of Children’s Outpatient services at the Royal Hospital for Sick Children have been busy packing, ahead of the move of the first children’s clinical services to the new facilities at the Royal Hospital for Children and Young People.

This move is being delivered in a phased approach, and already a number of administration teams have migrated and settled into their new environment.

Alongside the provision of outpatient face to face appointments, NHS Lothian will continue to make use of video call technology ‘Near Me’ for a number of appointments, offering greater flexibility as well as reducing the need for families to travel to attend in person.

The move plan, which was agreed with the full involvement of clinical teams, is not only helping to free up space at the existing Royal Hospital for Sick Children site, but is enabling NHS Lothian to continue to deliver paediatric clinics in a way which fully adheres to and supports social distancing.

Susan Goldsmith, Finance Director and Executive Lead for the project, said: “It is exciting to see the first of our Children’s services move to their new home at the Royal Hospital for Children and Young People. We have reached a significant milestone in this project’s journey, which is important to acknowledge and celebrate. 

“While delays to the opening of the new facility have been well publicised, I hope that as each service moves and appointments commence; patients, visitors and staff will be able to see just how impressive the facilities really are.

“Reaching this stage in the project has required a tremendous amount of work from the contractors on site, as well as our own project and clinical teams and for that I would like to say a huge thank you.”

While the first outpatient services settle into their new home, work on the final stages of the remedial and enhancement work in other areas of the building continues. Once this has been completed, and following final commissioning, the second phase in the move of NHS Lothian’s Children’s services will take place.

At this point, those services still situated at the Royal Hospital for Sick Children site will also move to the new building.

 Lothian MSP Miles Briggs said: “It is terrific that staff are finally able to move across to the new facilities at the Royal Hospital for Children and Young People, based at little France.

“This move has been a long time coming and I wish all NHS Lothian staff the best at their new home.”

FAQs

How do I know where my child’s appointment will be?

Your appointment letter will tell you where your child’s appointment is being held. If it is to be held at the new Royal Hospital for Children and Young People, you will also receive a phone call to make sure you know where you are going. 

Is there parking available?

Parking is available on site. Parking stewards will direct you to the most appropriate car park. A small number of spaces are also bookable in advance, but these are reserved for patients with the greatest need, based on clinical priority.

My child has an appointment at the RHCYP, how do I find out the latest travel information?

For the latest travel information, including up to date details on parking facilities, we encourage you to visit the following website – https://www.nhslothian.scot/GoingToHospital/Locations/RIE/Pages/default.aspx

With COVID ongoing, is it safe to bring my child to hospital?

Yes. We have separate areas for patients who have tested positive for COVID-19 and for those who have not. There are also a range of enhanced infection control measures in place, such as staggered appointment times to limit the number of people in any one area of the building, physical distancing within waiting areas and enhanced cleaning in consulting rooms between each patient.

My child has an appointment in August, does this automatically mean it will be in the new building?

No. Although most outpatient services are moving over the coming weeks, some will remain at the Royal Hospital for Sick Children site at Sciennes, until the new building is ready to be opened to all services, including inpatients. This is because some services need access to other clinical support, which will not be moving until the whole building is open. Departments that will not be moving at this stage include, but are not limited to: Pain, Respiratory (asthma, allergy, CF), Cardiology, Haematology Oncology, Plastics and Plastics dressings clinic.

Does the move mean that the reported problems in the building have been fixed?

Our project team, as well as the contractors on site, are continuing to work on the final stages of the remedial and enhancement work. Once this has been completed, and following final commissioning, the second phase of the move will take place.

Why has everything not moved across to the new building?

Remedial and enhancement work is still taking place at the new building, which means that some services cannot move at this time.

If my child has an emergency, where do I go?

Children’s Emergency Services remain at the Royal Hospital for Sick Children at Sciennes. If you need to access this service, you should continue to do so at the old site. There are no Emergency Services at the new building within the Little France site at this time.

It has been reported that the RHCYP building will be opening in Autumn 2020, are things on track for then?

Our project team, as well as the contractors on site, are continuing to work on the final stages of required remedial and enhancement work. As part of this, we are due to imminently receive the final works programme. Once this has been received and discussed with the services involved, an opening date for the full building will be announced, alongside more detailed plans for the migration of the remaining Children’s services. 

Partnership addresses people going missing from hospitals

A partnership between police and NHS Lothian has been hugely successful in reducing the number of people going missing from healthcare facilities in the Capital.

Between 2014 and 2015 analysis was undertaken by Police Scotland into the time and resource devoted to tracing those who left the grounds of the Royal Infirmary of Edinburgh, Royal Edinburgh Hospital and Western General Hospital.

The average amount of policing hours spent looking for an individual, who goes missing from an acute health unit, is over three hours. This figure rises to 15 and a half hours for those who absconded who go missing from mental health care units.

The analysis by Edinburgh Division officers alongside NHS Lothian staff NHS Lothian staff was used to formulate a strategy in order to address this issue.

As a result, an joint initiative was launched to help dissuade people who were attending hospital from leaving without first notifying staff.

The campaign, which included leaflets and posters for display in prominent locations, outlined what happens when someone goes missing, the associated costs involved and what people could do to ensure that they did not inadvertently become a missing person.

Posters and leaflets were displayed and distributed within these facilities advising the public that if they go missing, then family members, friends and even work colleagues may be contacted to establish their whereabouts.

The literature also provided an overview as to the associated policing costs of a missing person inquiry.

In addition to raising public awareness, information sharing protocols were agreed with NHS Lothian, which enable enhanced risk assessment, allowing us to take a more informed approach when responding to a missing person case. to each case.

Since the launch of this campaign, the number of missing people from hospitals in Edinburgh reduced by 26% in 2019.

Work continues to reduce these numbers further to relieve the burden on frontline policing and spare families from the distress of a loved one going missing.

Chief Inspector Neil Wilson from Edinburgh Division said: “The reasons why a person goes missing are often complex and varied and the purpose of this initiative was as much to understand these issues, as it was deterring people from becoming a missing person.

“We, along with our partners, felt it prudent to inform the public about what actually happens once they are reported missing and what that means for their family, friends and colleagues, as well as the staffing hours incurred by police and NHS staff.

“The support this project has received from NHS Lothian has been outstanding and demonstrates a real commitment to joint working. and they have demonstrated a real commitment to mitigating against people going missing from their premises.

“It is great to see this initiative having such a positive impact, however neither agency will become complacent in our efforts, as we continue to work together to minimise the number of people who go missing from Edinburgh’s hospitals. “

Dr. Tracey Gillies, Medical Director, NHS Lothian said, “I would like to thank Chief Inspector Wilson and his team for their continued support, as together we respond to this important issue.”

Briggs: NHS Lothian Covid-19 funding fears

In May, the NHS Lothian Local Mobilisation Plan (LMP) forecast additional costs of £149.8m associated with the COVID-19 response across the Board and four HSCPs (health and social care partnerships). Of this, £71m is anticipated in the four months to the end of July.

Scottish Conservative Health Spokesperson, Miles Briggs, said: “NHS Lothian was facing significant financial challenges before Covid-19 struck and now these financial challenges are even greater.

“SNP Ministers must ensure that health boards are properly funded to deliver essential health services during this public health crisis and have appropriate measures in place.

“The poor management of NHS Boards by consecutive SNP Health Secretaries has meant that NHS Scotland was not in as strong a position as we should have been to deal with this crisis.

“Waiting times for operations are going to be longer in all health boards and I do not have confidence that SNP Ministers will be able get on top of these long treatment waiting times.”

Rehabilitation support available to Covid-19 patients in Edinburgh and Lothians

Lothian MSP Miles Briggs has praised Chest Heart & Stroke Scotland’s work to reform the way people with lung conditions access rehabilitation and support.

Covid-19 is expected to lead to a dramatic increase in the numbers of people managing what will possibly be long-term lung conditions and needing support for rehab and recovery.

Chest Heart & Stroke Scotland have been working with NHS Lothian to make rehabilitation support to accessible to patients who are recovering from Covid-19.

A total of 2,807 people in NHS Lothian have been confirmed as having Covid-19 since that start of the outbreak.

As of 16 June, 131 patients were in NHS Lothian hospitals with Covid-19, 193 patients with suspected Covid-19 and 6 patients in Intensive Care.

3,929 patients who have tested positive for Covid-19, who have previously required hospital treatment, have now been discharged from hospital since the start of the outbreak, with the most serious cases having longer term conditions.

A full list of measures put into place by NHS Lothian and CHSS Scotland is included below.

Lothian MSP, Miles Briggs, said: “I am pleased that NHS Lothian have put a range of measures in place to support survivors who have had severe cases of Covid-19.

“Having rehabilitation support in place for patients is crucial for their recovery and quality of life after having Coronavirus.

“The Covid-19 pandemic will have an impact on NHS Scotland for years to come, with increased waiting times for treatments.

“Prevention and recovery will be more important than ever for keeping people in Scotland healthy.

“I have called on SNP Ministers to develop a national Covid-19 rehab strategy to support people who will have long term health conditions from contracting Covid-19.”

Measures put into place by NHS Lothian and CHSS

Establishment of a comprehensive rehabilitation and support pathway for survivors of severe COVID across all three Lothian acute sites.

An Multidisciplinary Team (MDT) discusses all cases weekly, and agrees personalised requirements for physiotherapy, dietetics, Occupational Therapy (OT), and Speech and Language Therapist (SLT).

In addition, all patients have psychological review and support.

Case management is coordinated by an Intensive Care Unit (ICU) trained nurse, who uses previously established pathways to liaise with relevant health-social care hubs, GPs, pharmacy, and other community based services in relation to anticipatory discharge planning and support post discharge.

Rehabilitation services at Astley Ainslie Hospital (AAH) join the weekly Multidisciplinary Team and where appropriate review patients and transfer them at an appropriate time to the AAH.

NHS Lothian are also working with Chest Heart & Stroke Scotland (CHSS) to liaise with their community staff (who are linked with the Managed Clinical Network (MCN) for respiratory).

NHS Lothian are producing a patient/family information resource for COVID survivors in collaboration with CHSS (funded in part by the Edinburgh and Lothian Health Foundation).

There has also been a community advice line resource set up by therapists in Edinburgh which allows patients to access community services such as pulmonary rehabilitation’.

More services to move to New Sick Kids

NHS Lothian has announced that from July 20, a number of children’s outpatient services will move to the new Royal Hospital for Children and Young People (RHCYP) at the same time as remaining services from the Department of Clinical Neurosciences (DCN) complete their move.  

A phased move will see some Children’s outpatient services, including Neurology and Orthopaedics migrate, along with a number of administrative support staff.

The plan, which has been agreed with the full involvement of clinical teams, will not only help to free up space at the existing Royal Hospital for Sick Children site, but will enable NHS Lothian to continue to deliver paediatric clinics in a way which fully adheres to and supports social distancing.

Susan Goldsmith, Director of Finance and Executive Lead for the project, NHS Lothian, said: “Delays to the opening of the new Royal Hospital for Children and Young People have been well publicised, but today we celebrate this important milestone for children’s services in Lothian.

“We are delighted to make this announcement, and look forward to welcoming our first outpatients in July, who will be able to benefit from the fantastic facilities and surroundings on offer.  It goes without saying that this move would not be possible without the continued hard work and support from our project team, as well as the contractors on site.

“Whilst we celebrate this moment, I know many people will be wondering when the rest of our children’s services will open at the new site. It very much remains our aim to complete the full migration of children’s services to the RHCYP in the Autumn. We are mindful, however, of the ongoing COVID-19 situation, which may yet impact supply chains and the pace of work, as contractors on site observe safe social distancing, but at present the work is progressing on track.”

The final phase of the move of the Department of Clinical Neurosciences (DCN) will also take place in mid-July. This will see inpatient Neurosurgery and Neurology wards, along with Neurosurgery Theatres and Interventional Neuro-Radiology relocated to their new home from July 13. The very few remaining DCN outpatient services will also make the transition from the Western General Hospital to the Edinburgh Bio Quarter site at Little France.

Jacquie Campbell, Chief Officer, Acute Services, NHS Lothian, said: “This will mark the beginning of an exciting new chapter in the provision of these highly specialised services for our patients.

“It will also represent a huge moment for those DCN staff who have remained at the Western General Hospital to support our Covid-19 response. They are really looking forward to providing world class treatment and care in superb facilities at the new Department of Clinical Neurosciences.”

FAQs on Children’s Services Outpatients Move

How do I know where my child’s appointment will be?

Your appointment letter will tell you where your child’s appointment is being held. If it is to be held at the new Royal Hospital for Children and Young People, you will also receive a phone call to make sure you know where you are going. 

Is there parking available?

Parking is available on site. Parking stewards will direct you to the most appropriate car park. A small number of spaces are also bookable in advance, but these are reserved for patients with the greatest need based on clinical priority.

With COVID ongoing, is it safe to bring my child to hospital?

Yes. We have separate areas for patients who have tested positive for COVID-19 and for those who have not. There are also a range of enhanced infection control measures in place, such as staggered appointment times to limit the number of people in any one area of the building, physical distancing within waiting areas and enhanced cleaning in consulting rooms between each patient.

My child has an appointment in August, does this automatically mean it will be in the new building?

No. Although most outpatient services will be moving in July, some will remain at the Royal Hospital for Sick Children, until the new building is ready to be opened to all services, including inpatients. This is because some services need access to other clinical support, which will not be moving until the whole building is open. Departments that will not be moving in July include, but are not limited to: Pain, Respiratory (asthma, allergy, CF), Cardiology, Haematology Oncology, Plastics and Plastics dressings clinic.

Does the move mean that the reported problems in the building have been fixed?

Our project team, as well as the contractors on site, are continuing to work on the final stages of the remedial and enhancement work. Once this has been completed, and following final commissioning, the second phase of the move will take place. At this point, those Children’s services still situated at the Royal Hospital for Sick Children site will migrate to the new building.

Why has everything not moved across to the new building?

Remedial and enhancement work is still taking place at the new building, which means that some services cannot move at this time.

If my child has an emergency, where do I go?

Children’s Emergency Services remain at the Royal Hospital for Sick Children at Sciennes. If you need to access this service, you should continue to do so at the old site. There are no Emergency Services at the new building within the Little France site at this time.

Does this move set in motion a timeline for the full building to be open and can you tell us when that will be?

This is the first phase in the move of our Children’s Services to the Little France site. We have made significant progress on the Royal Hospital for Children and Young People and Department of Clinical Neurosciences (DCN). It is possible that changes may have to be made to the work programme and the delivery of the Royal Hospital for Children and Young People.

It has been reported that the RHCYP building will be opening in Autumn 2020, are things on track for then?

Possible changes may have to be made to the programme and the delivery of the Royal Hospital for Children and Young People.

Given the current climate, this may not come as a surprise, but because of the complexities involved and the impact of COVID-19, which could never have been predicted, the timeline for a full handover is under review.

A revised works programme is being established, which will be as close to the Autumn timeline as possible.

Lothian MSP, Miles Briggs, said: “The moving of services to the new Royal Hospital for Sick Children is long overdue, but I am glad that this could finally present the beginning of the end of what has been a national scandal surrounding the SNP Governments mismanagement of the new Sick Kids Hospital.  

“It is vital assurances are provided surrounding the remedial works and inspection regime at the hospital so that it adheres to the highest health and safety standards. I will be seeking assurances from SNP Ministers before patients and staff move to the hospital.

“Above all families across the East of Scotland will welcome the fact that we hopefully will soon see the full opening of a state of the art hospital to help our NHS professionals provide the care and treatment for our loved ones that we all want to see.

“I look forward to visiting the new Royal Hospital for Sick Children once lockdown measures have been eased and it is safe to do so.”