A&E WAITING TIMES PROBE
Whistleblower tells of misreporting
St John’s Hospital in Livingston is under investigation after a whistle blow er revealed staff had been misreporting waiting times.
The number of patients waiting four hours or more for treatment at the hospital’s A&E department may have been wrongly recorded as staff felt pressured to adhere to strict guidelines.
This means some patients who may have been recorded as breaching the waiting time performance target were not included in departmental performance reports.
An internal review found emergency department workers had been following their own guidelines on how to record patients who were found to have waited more than four hours, instead of following national guidance.
Shona Robison, the Cabinet Secretary for Health, requested the internal investigation and an immediate review was launched
in line with nHs Lothian’s Whistleblowing policy.
initial findings have highlighted areas of non-compliance for further investigation and the Health Minister has since requested an independent, external review of practices by professor derek Bell, chair of the academy of Medical royal Colleges.
Jim Crombie, deputy chief executive of nHs Lothian, said:“nHs Lothian are 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.”
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.
But the initial draft report also found no evidence of bullying or harassment 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 will be shared at the next public board meeting of nHs Lothian on december 6.
professor derek Bell, chair of the academy of Medical royal Colleges and Faculties in scotland, said:“We are concerned to learn of the problems reported by nHs Lothian around a&e waiting times practices and staff pressure at st John’s Hospital.
“We recognise that doctors and other nHs staff should be supported in raising concerns about poor practice. ensuring that they have the ability to speak up and are encouraged so to do without risk or adverse impact on their careers is essential and will improve patient care.
“the scottish academy have the objective expertise and contextual knowledge required to support an independent review, working with nHs Lothian, to address to address the problems highlighted.”
snp Msp Fiona Hyslop said she was pleased the Health secretary had “moved swiftly”to investigate concerns.
she said:“it is vital we have transparency and accountability so this is a necessary and appropriate step.”
Lothian Msp and Conservative shadow Health secretary Miles Briggs Msp said:“West Lothian residents will be looking for very clear reassurances that the current system of recording a&e waiting times at the local hospital so many of them rely on has not been designed to minimise or mask excessive waits that break the scottish government’s four hours target.”