Patients ‘sleeping on recliner chairs’ in overcrowded hospital, inspection finds

Some patients at an Ayrshire hospital spent up to 28 hours on trolleys in corridors while waiting for treatment, with others spending three days on recliner chairs before being admitted, according to a report.

Inspectors at Healthcare Improvement Scotland visited University Crosshouse in Kilmarnock in May and found incidents of patients waiting up to 28 hours for treatment in the combined assessment unit (CAU) for a full day, being cared for in mixed sex bays, overcrowding and staff shortages.

A report published on Wednesday showed older adults waiting to receive treatment did not always have care needs such as personal hygiene or food and nutrition met.

Patients could often be sleeping in recliner chairs for up to three days, inspectors were told, increasing the risk of pressure sores.

Inspectors felt NHS Ayrshire and Arran was unable to show they could manage these patients safely and managers did not have sufficient oversight of care provided in both accident and emergency and CAU areas of the hospital.

Additional beds were found in some six-bay wards that did not have oxygen facilities or power outlets for monitoring equipment as part of the hospital’s full capacity plan.

When inspectors challenged hospital bosses on this, they were advised staff should check patients met the clinical criteria to be placed in an additional bed.

The report also found re-direction and signposting guidance was not always in place for patients who did not need to attend accident and emergency.

At the time of the inspection, the fire alarm sounded but staff were not able to move patients because they did not know how.

Staff were praised for their teamwork and kindness towards patients they were caring for and the report recognised they were working hard to ensure patients were well cared for and their care needs were met.

The report also recognised the staff shortages and high number of vacancies within the health board.

Covid-19 protocol was followed well and staff consistently asked patients and staff entering the hospital screening questions.

Commenting on the report, Donna Maclean, head of service, Healthcare Improvement Scotland, said: “At the time of inspection, University Hospital Crosshouse was experiencing a significant range of pressures associated with Covid-19, including increased hospital admissions, increased waiting times in emergency departments and reduced staff availability.

“During our inspection we observed staff in clinical areas working hard to provide care.

“We observed examples of good teamwork and communication, and positive interactions between staff and patients.

“We also observed staff shortages and overcrowding, due to increased patient numbers, and we identified that patient care needs were not always being met.”

A further inspection will take place to ensure concerns are being addressed.

The health board said they are “committed” to the provision of high standards of care and that they value scrutiny of services.

A spokesperson for NHS Ayrshire & Arran said: “We acknowledge and fully accept the findings of the recent Healthcare Improvement Scotland’s (HIS) report following their unannounced inspection of University Hospital Crosshouse in May.”

“NHS Ayrshire & Arran has well established mechanisms for staff to raise concerns, including through line managers, via safety huddles, Datix (a patient safety organisation) and the wellbeing team.

“We would encourage all staff to access these channels, where they will be supported to raise concerns, be listened to and have their concerns acted upon.”

Scottish Labour’s Jackie Baillie called for action to tackle the issues “engulfing” hospitals such as Crosshouse and accused the Scottish Government of neglecting the health service.

Scottish Conservative spokesman Craig Hoy said the report was not a reflection on NHS staff and accused the Scottish Government of “desperate mismanagement” of Scotland’s NHS.

A Scottish Government spokesperson said: “Patient safety is a key priority. We expect NHS Ayrshire and Arran to address any outstanding concerns Healthcare Improvement Scotland have identified as a matter of urgency, and will support them to do so.”

Meanwhile, Unison, the trade union representing healthcare workers across Scotland, said NHS staff have endured 10 years of real terms pay cuts and is facing challenges to recruit staff, resulting in shortages in hospitals.