Inspectorate raises concerns over pressures faced by Edinburgh hospital

Issues around reduced staff availability, increased waiting times and hospital admissions have been raised in the inspection of an Edinburgh hospital.

In a report released on Monday, Healthcare Improvement Scotland said that “the Western General Hospital, like much of NHS Scotland, was experiencing a significant range of pressures including increased hospital admissions, increased waiting times in admission units and reduced staff availability” when it visited earlier in the year.

An unannounced inspection of the hospital was carried out across two days in July, with a further visit held in September to ensure that concerns previously raised had been addressed.

The report said that certain areas within the campus were working with “less than optimum staffing levels” due to absences and a lack of available supplementary staff, while the lack of an emergency department at the hospital meant all unscheduled care attendances were observed to have required coming in through the medical assessment, surgical admission or same-day emergency care units.

It added that there were no medical or receiving beds available at the start of the day for new admissions, with 10 surgical beds available – less than 2% of those available to admit new patients – despite there being 16 patients awaiting admission.

However, the inspectorate praised the “person-centred approach” adopted by staff members, and said it “observed multi-disciplinary staff in clinical areas working hard to ensure the patients were well cared for and their care needs were met”.

But it said areas with gaps in senior staff roles presented higher levels of stress within ward teams, and set a requirement for the NHS Lothian health board to ensure effective processes are put in place to support clinical staff “where there is an absence of the expected senior leadership and management roles within the team”.

Dr Tracey Gillies, medical director at NHS Lothian, said: “Across the NHS, services and staff are under considerable pressure and NHS Lothian is no exception to this. Despite this, it is pleasing to see many areas of good practice have been recognised within this report particularly around patient care.”

She added: “We note that there were some areas that the inspectors felt could be improved and an action plan has been developed to address these.”