Edinburgh health care staff shortage reaches critical condition

Shona Oliver with her father, Bill. Picture: Lesley Martin

A report by Healthcare Improvement Scotland (HIS) criticised poor staffing levels, weaknesses in record-keeping and a lack of leadership.

In one ward, the inspectors had to step in twice after staff failed to respond to patients pressing buzzers for help.

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The inspections came after the Evening News told how grandfather and RAF veteran Bill Oliver, 82, died at Ellen’s Glen House in Liberton, where his family said he was left without painkillers for days.

Daughter Shona, 51, from Morningside, described how one day they found him “roaring” in pain. On another occasion he was dehydrated and surrounded by mugs of tea and glasses of water that he was too weak to lift. She said a senior medic had told them staffing levels were “dangerously low”.

As well as Ellen’s Glen, HIS visited Ferryfield House in Pilton, Findlay House in Seafield and Astley Ainslie in the Grange. Together, the four locations care for almost 190 patients with complex needs.

The HIS report noted “a lack of staff presence” in the wards and patients waiting over five minutes until their buzzer was answered. “In the frail elderly ward in Ferryfield House, we intervened on two separate occasions to assist patients who were calling for assistance and had waited five to ten minutes.”

Lothian MSP and Tory public health spokesman Miles Briggs said the situation was shocking.

He said there were shortages at many levels – specialists, nurses and care assistants. “The government will say it’s the health board’s  responsibility, but I don’t think health boards know how to address this without a real government focus,” he added.

The HIS report said the increasingly complex needs of patients in the wards needed a workforce with the right skills and enough time to meet the demands. It states: “NHS Lothian has made a significant investment in staffing across the service. However, in common with other NHS boards across Scotland, it is experiencing difficulties in recruiting and retaining the right staff.”

It said employees had reported that bank and agency staff were regularly used to cover sickness absence, maternity leave and annual leave, which had the potential to compromise the quality and continuity of care.

“The senior management team reported that sickness absence was an ongoing challenge,” the document states. “This averaged at 12.8 per cent, though it was as high as 23 per cent in Findlay House. There is a need to continue to address pressures on the system in respect of staff vacancies, sickness absence and temporary staff.”

Scottish Labour leader and Lothian MSP Kezia Dugdale said people across Scotland would be shocked.

She added: “The sad reality is that it is a symptom of years of crisis management in our NHS with no credible long-term planning from the SNP government. Hundreds of millions of pounds of cuts to local services will only make this worse because it will increase the pressure on hard-working NHS staff and it will be patients who lose out.”

Age Scotland congratulated Mr Oliver’s family for bringing “these examples of shockingly poor care” to light. A spokesman said: “This highlights the need for friends and families of those in care to be vocal about those in care and to take action.

“We would hope this report will bring swift action to rectify any failings in the care of some of the most vulnerable in society. It is vital that the right resources are in place to deal with these issues and that regulators have the powers they need to act as an effective watchdog and ensure that such incidences don’t happen again.”

Lothian MSP and Green health spokeswoman Alison Johnstone said: “This shocking report underlines the need to invest in staff and facilities that can cope with Scotland’s changing health and social care needs. We have an ageing population and increasingly complex health conditions, and to hear of hospital inspectors having to intervene due to poor staffing levels does not instil confidence in the future.”

And Liberal Democrat health spokesman Alex Cole-Hamilton, MSP for Edinburgh Western, said: “The Scottish Government and health boards need to look to the recruitment and retention of vital frontline staff.”

Health Secretary Shona Robison said: “It is disappointing that in this instance the care delivered fell short of the high standards that patients rightly expect and deserve.

“NHS Lothian has already taken steps to implement the recommendations contained in the report and has given assurances they will continue with this work to ensure the highest quality of care can be  delivered.”

Professor Alex McMahon, director of nursing at NHS Lothian, said the review highlighted many areas of good practice but accepted there were “areas where we need to improve”.

He said: “A robust action plan was developed and many of these points have already been addressed as a matter of urgency. Over the last year, NHS Lothian has invested  £1.3 million in the service to maintain the correct balance of levels and skill mix of staff and ensure they are appropriate to the needs of patients. Record-keeping has also been targeted and the importance of clinical management standards has also been reinforced with staff.”

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