Hundreds of under-staffing alerts revealed at NHS flagship as nurses fear for patients
Medical staff log hundreds of reports raising alarm over staffing levels as nurses warn crisis is mirrored in wards across NHS Scotland
Hundreds of alerts over staffing levels have been logged at Scotland’s flagship NHS hospital, we can reveal.
The official reports include 55 “near-miss” incidents where there was the potential for a patient to be harmed because of staff shortfalls.
Staff at Queen Elizabeth University Hospital (QEUH) in Glasgow have warned of understaffing on the Datix system 339 times since 2019. Yesterday, nursing leaders warned the escalating crisis meant patients and staff were at risk.
One clinician at the hospital said the reports were the tip of the iceberg as staff are reluctant to use the NHS system designed to report incidents. He said: “If you have been told about 300-plus then double that number, triple it. They are a drop in the ocean.
“If the Datix system is not deliberately designed to put people off filing reports, then it sometimes feels like it. Page after page, drop-down menu after drop-down menu, it is a complete faff and takes far too long. It is the opposite of user-friendly. People only fill out reports to cover their backs in case whatever has happened has repercussions. The idea that these reports might actually raise the alarm and prompt action is no longer even a consideration.”
He said daily meetings assess the ratio of nurses on wards to patients, grading them green, for safe, amber and red. “I can tell you there are red wards every day. Two nurses for 28 patients when there should be six, seven or eight. I’ve heard of one nurse for 28 patients but it’s untenable, a vicious circle.
“No one can cope working like that, so people end up going off sick, stressed and disillusioned, then we’re even shorter of staff.”
The Datix figures reveal how wards across the 1,100-bed hospital, including cardiology and assessment units, were shortstaffed. Sources suggest the situation worsened dramatically during the pandemic but say the data, obtained under freedom of information legislation and detailing alerts from the beginning of 2019 to the end of August, reveals staffing levels were causing concern long before Covid.
In July, we told how accident and emergency wards
were buckling under the strain of too many patients and too few staff, with waits of up to 12 hours for a bed.
Yesterday the first Army drivers – called in by the Scottish Government as the crisis deepened – began manning ambulances across the central belt.
Staff lodged their concerns on the hospital’s Datix incident reporting system, used in health authorities across the UK to allow workers to flag up a wide range of problems and events of concern.
Understaffing of appropriate health workers was reported 70 times in a high-pressure cardiology ward where heart patients are fighting for their lives. Cardiology requires more nurses per patient, including one to monitor cardiac telemetry – a way of checking a person’s vital signs, including their heart rate, breathing and blood pressure.
The highest number of nearmisses – nine in total – took place in the Immediate Assessment ward, which deals with patients sent to hospital by their GP for urgent treatment. The figures relate to the adult hospital at the QEUH and not the attached Royal Hospital for
‘ This crisis has been years in the making
Children and Maternity Hospital based on the same campus.
A source at the hospital said the understaffing problem was getting worse, saying: “Covid has undoubtedly made it worse but this crisis has been years in the making. We have not trained enough nurses, doctors and other health professionals and many of those that did enter medicine are now leaving.
“Some who worked through necessary degrees for a health career have left because they were worked to exhaustion, covering those staff shortages. Others emigrate or find work in other sectors.”
Royal College of Nursing Scotland said nursing and midwifery vacancies are at a record high of 4,800 – 7% of available posts – and said the situation at the QEUH was far from unique in Scotland’s hospitals.
The union’s Scotland director Colin Poolman said: “The stories we are hearing from members across Scotland’s hospitals and community services are deeply worrying. They are telling us that they have genuine concerns for patient safety and their own health and wellbeing.
“As a safety-critical profession, nursing has been undervalued and under-resourced for too long. The pandemic has compounded years of working under the pressure of staff shortages and with pay that has failed to keep pace with the cost of living.”
He said Scotland needed a robust plan to increase the future workforce to a sustainable level and to encourage the existing workforce to stay.
“A fair pay rise for nursing staff and implementation of Scotland’s safe staffing legislation – the Health and Care (Staffing) Act – would go some way to addressing the staffing challenges.”
Scottish Labour Deputy Leader Jackie Baillie pointed to a failure to invest in an adequate number of staff to ensure safety levels in hospitals. “It is clear that there is insufficient staff to meet demands on the NHS,” she said. “The level of vacancies is also far too high – from nurses to the most senior consultants.
“The Scottish Government
has failed at workforce planning – and there have been three workforce plans published in the last parliament.
“Nurses and clinicians are not listened to and we now have a number of baby boomers retiring. One geriatrician told me they were forced to leave at 60 because their health board would not accommodate a lower-hour contract and fewer weekends on-call working in the early hours of the morning.
“Nicola Sturgeon reduced the number of nursing training places a decade ago and these people would be skilled now and able to work in the NHS. Warnings were given at the time.
“Staffing is the single most significant issue now. We have asked the government to ask newly retired staff to come back, even part-time, to cope with the oncoming winter pressure. I dread to think what it will be like with the current level of staff. Add to that the fact that many staff have no access to hot food or rest places for breaks, which would show we care for them.
“We need 1,000 more beds and the staff to care for those patients safely.”
NHS Greater Glasgow and Clyde said: “Across Scotland there have been significant pressures on NHS Scotland. Any existing staffing issues have been exacerbated by Covid.
“We have taken steps to bring on board 670 newly qualified nurses. Of this total, 573 are already in post and the remaining 97 will start with us fully as soon as their registration is processed. We would like to thank those who agreed to join us early, to provide key support to our services, for which we are very grateful.
“In addition to these new nurses, we are pleased that around 500 more Health Care Support Workers (HCSWS) are joining our bank to support us during the winter.
“We accept, however, that challenges remain, and we will continue to look at solutions to support our staff and to ensure they can continue to deliver safe effective patient centred care. Datix reporting will play an ongoing role in helping us explore any concerns and respond appropriately.”
The Scottish Government said: “Staffing levels in Scotland’s NHS have reached a new record high after an increase of over 5,000 whole time equivalent staff in the last year. Thanks to nine consecutive years of staffing increases, we have an extra 25,000 staff working in our health service, an 11% increase in qualified nurses and midwives and a steady rise in places on pre-registration nursing and midwifery undergraduate training programmes.
“We recognise the acute workforce capacity challenges across NHS services and we are working hard to bring in new capacity and realign existing services to continue to provide timeous, effective and appropriately prioritised care.
“We have published our NHS Recovery Plan with more than £1 billion of targeted investment, including a commitment to provide £11 million for new national and international recruitment campaigns and to establish a national Centre for Workforce Supply.”