Covid wave Dozens of wards were potentially unsafe, inspectors find

DOZENS of wards at Glasgow’s superhospital were considered potentially unsafe for patients at the height of the latest Covid wave, inspectors have found.

An unannounced inspection carried out by the Healthcare Improvement Scotland team between March 22 and 24 found that 33 wards across the Queen Elizabeth University Hospital campus were scored “red”, signalling

“that nursing staff numbers or skill mix may be creating a risk to patient safety, or there are issues affecting patient safety that requires immediate attention”.

Inspectors said: “During the inspection, we observed senior managers and lead nurses working together at regular site safety huddles to consider possible actions to mitigate risks where a red score was reported.

“These options included redeploying staff from areas, such as theatres, where scheduled procedures had been cancelled.

“In addition to this, efforts were made to support discharging patients who would be able to go home.

“However, we observed

that there were still not enough staff available to reduce the risk in all of the red areas and a number of clinical areas continued to be a red risk score.”

At the time of the visit, one in 10 registered nurse posts was vacant and a further 9.3 per cent of the nursing workforce was absent for reasons including sick leave.

Among the medical staff, the vacancy rate was 1.4% with a further 2.2% of doctors off sick.

Despite “significant staff shortages throughout the hospital campus”, inspectors praised evidence of “effective leadership, clear communication and effective levels of care”.

They stressed that the inspection had taken place at a time when the hospital had the highest number of Covid-19 patients in Scotland, but that “overall patient satisfaction remained high during this time”.

A majority of patients “described the care they received as very good, with high admiration for the staff delivering the care”.

However, there were “extreme bed pressures”, with one patient spending 17 hours in A&E waiting to be transferred on to a ward and only 5% of the staffed beds in use were empty. Bed occupancy over 85% is considered unsafe.

Meanwhile, respiratory symptom patients who had been diverted into a separate holding bay knowing as the Specialist Treatment and Assessment Area (SATA) spent hours “being cared for on chairs in a lounge area... due to the demand for inpatient beds exceeding the number of available beds”.

One patient in the SATA was being “cared for in a room previously used as a store room” which had no viewing pane enabling staff to monitor them, and where lights could not be turned off.

However, inspectors noted that most of the patients were kept in the same a seating area – a former discharge lounge – which increased the risk of cross-contamination between people with different respiratory infections.

They said: “The national guidance recognises that it may be necessary to care for patients with different respiratory infections in one multi-bed care area before being admitted to a single room.

“However, it states this does carry the risk of different infections being spread, should be avoided wherever possible and only used as a last resort during times of extreme bed pressures.

“Our observations during this inspection were that this hospital was experiencing extreme pressures.”

Inspectors also raised concerns about staff moving between different areas of the SATA without changing their personal protective equipment (PPE), and of PPE not being stored properly to prevent contamination.

On a follow-up visit on April 13, however, inspectors found that these issues had been rectified and the store room was no longer being used for patients.

Jane Grant, chief executive for NHS Greater Glasgow and Clyde, said: “Despite unprecedented pressure across the service at a time where staff were looking after around 700 Covid-19 patients across NHSGGC, including one third in the QEUH alone, staff continued to show the utmost professionalism and compassion in treating patients, while also working exceptionally well with each other to make very tough decisions on an hourly basis.

“The challenges posed by Covid during that period cannot be understated and it’s thanks to all staff at the QEUH that we’ve been able to successfully weather the storm and continue to deliver highquality care to patients.

“However, while the report highlights these positives in the context of the wider pressures caused by Covid-19, we accept that there were also some improvements which could be made in some areas of the hospital. As such, we can confirm we have now acted upon all of these, with improvements either complete or with an ongoing monitoring plan in place.”