Western General Hospital has ‘appalling’ hygiene

The Western General Hospital, Edinburgh. Pic: Cate Gillon
The Western General Hospital, Edinburgh. Pic: Cate Gillon
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HYGIENE standards at the Western General Hospital have been branded “appalling” by patient groups after a damning report by a health watchdog.

The Healthcare Environment Inspectorate (HEI) rated levels of cleanliness as “poor” following two unannounced visits in November last year.

Inspectors found equipment was dirty, wards were overcrowded and hand gels had been wrongly removed.

Bed handrails, mattresses, armchairs and toilet-roll dispensers were contaminated and there were concerns raised about the risk of cross-infection to patients, staff and visitors.

They raised “significant concerns” with senior management at NHS Lothian “about the cleanliness of patient equipment and environmental cleanliness”.

Dr Jean Turner, former executive director of Scotland Patient Association, said the conditions were putting patients at risk.

She said: “It is absolutely horrifying. We’re not a third-world country and we expect our hospitals to be clean.

“This is shocking at a time when we’re battling hospital infections. These are the basics that we’re failing at and NHS Lothian has got to ask itself why. If it’s a matter of not having the staff, and the nurses can’t do it, then we need more cleaners. It shouldn’t take an inspection by the HEI for hygiene to improve.”

Sixteen of the 21 commodes examined were covered in faeces, blood or body fluids and two were two damaged, meaning they couldn’t be cleaned properly. Of the 18 mattress covers inspected, seven were found to be contaminated.

Macerators used to dispose of human waste were not working, so staff were having to dispose of it in a patient toilet. One patient complained the toilet and shower room in their ward could be cleaner, saying “seats plus floor has been covered in faeces a few times”.

Sarah Boyack, Labour Lothian MSP, said the findings were “deeply concerning”, particularly given the health board’s dismal record with hospital-acquired infections.

She said: “It shouldn’t take an unannounced visit to deliver proper standards of hygiene. These are basic failings in cleanliness which clearly undermine the environment that patients are treated in.”

Inspectors issued NHS Lothian with eight requirements and one recommendation – twice as many as after a previous inspection in 2013.

Susan Brimelow, HEI chief inspector, said: “We requested that NHS Lothian take immediate action to address these issues and produce an improvement action plan.

“We returned unannounced on Thursday, November 27, and found that significant improvements had been made.”

Melanie Johnson, executive nurse director at NHS Lothian, said staff had acted on the inspectors’ findings as “a matter of urgency”.

She said: “We recognise that some standards were below those we would expect and I apologise to any patients who may have been affected. I would also like to reassure them that those areas have been rectified.

“A detailed action plan was drawn up and all points have been completed.”

Damaged and not cleaned properly

• The standard of cleanliness of patient equipment was poor.

• A lack of appropriate risk assessments, for example for out-of-order macerators.

• Sixteen of the 21 commodes examined were contaminated, while seven of the 18 mattress covers inspected were also dirty.

• Two out of five commodes on one ward were damaged and could not be cleaned effectively.

• Faecal contamination to patient handrails in toilets (ward 4) and to toilet-roll dispensers.

• Mould was found on some shower heads and shower surrounds.

• Dust was discovered on extraction vents in the toilet and shower rooms in wards.

• Hand gel was not available in some wards.

• The drain covers in two patient showers were found to be dirty and stained.

• Sharp instruments management was generally good, with some exceptions, which were rectified at the time of inspection.

• A good supply of personal protective equipment (PPE), including gloves and aprons, was available on the wards and departments inspected.