NHS Ayrshire: Inspectors hail patient safety improvements

Healthcare Improvement Scotland has published reports from a follow-up inspection to University Hospital Crosshouse and a focused inspection visit to University Hospital Ayr. The visits took place in July 2023.

And the new report concludes: "We are assured progress has been made in NHS Ayrshire and Arran to satisfy the serious patient safety concerns raised."

Those concerns were raised during an unnannounced inspection at Crosshouse in May 2022.

Inspectors found in some parts of the hospital, patients were being cared for in non standard care areas and mixed sex bays which affected patients’ care, dignity and respect needs.

The team observed and were told by patients and staff that patient care needs, including nutritional and personal care needs, were not always being met.

They observed increased patient numbers, overcrowding, staff shortages and inconsistent implementation of some of the NHS board’s own policies. This raised concerns around the safe delivery of care.

The 2022 report revealed: "Some staff told us that they feel unsafe or unsupported declaring risks or concerns around staffing, advising us they no longer complete the incident reporting forms in relation to these risks.

"We were told by staff that despite wards being declared 'safe to start' at the safety huddle, they were working with less than optimum staffing levels and skill mix. They expressed concerns that this presented a safety risk for patients."

The latest report states: "The purpose of the follow-up inspection of University Hospital Crosshouse was to assess progress and provide assurance on improvement actions in response to serious patient safety concerns that were identified and escalated during a previous inspection of the hospital in May 2022.

"An inspection of University Hospital Ayr was carried out in conjunction with the follow-up inspection of University Hospital Crosshouse to provide assurance of NHS Ayrshire and Arran board wide improvement actions."

And the new results were good for both hospitals.

Donna Maclean, chief inspector, Healthcare Improvement Scotland, said: “During our follow up inspection of University Hospital Crosshouse, we observed an open and supportive culture with senior hospital managers displaying good oversight of both clinical and wider system pressures, including a focus on patient safety.

 “Staff knowledge and awareness of fire safety procedures has improved and we saw staff were focused on the provision of safe and compassionate care.

"Wards were calm, organised and well led and patients and visitors were complementary about staff and the care they provided.

“We found similar levels of care during our inspection of University Hospital Ayr where all areas inspected were calm and well organised. Patients again were complementary about their care describing the patience, kindness and respect shown to them by staff.

“We also observed supportive multidisciplinary real time staffing discussions with a strong focus on patient care and safety with senior colleagues and managers working together to provide support, reduce and mitigate risks.

“On completion of both these inspections we are assured of the progress NHS Ayrshire and Arran has made to satisfy the serious patient safety concerns we raised following our inspection in May 2022.”

Nine of the 13 requirements from the earlier reports have been met. Four other requirements have been carried forward for further work to be undertaken.

Areas for improvement have also been identified at University Hospital Ayr including the safe storage of medicines, cleaning products and clinical waste.

An improvement action plan has been developed by NHS Ayrshire and Arran in order to meet the requirements at both hospitals.

A spokesperson for NHS Ayrshire and Arran said: "NHS Ayrshire & Arran is committed to the provision of high standards to ensure our patients receive safe and dignified care at all times. Our teams have a strong focus on ensuring that improvements are made to deliver the best possible care across health and social care services.

"NHS Ayrshire & Arran values scrutiny and inspection of our services as a learning organisation. We acknowledge the recent Healthcare Improvement Scotland’s (HIS) report following their follow-up inspection visit to University Hospital Crosshouse and the focused inspection visit to University Hospital Ayr.

"The report highlighted an open and supportive culture, with our teams focused on providing safe and compassionate care to our patients. We acknowledge that there are areas where we need to make further improvements, and these have been addressed in our action plan.

"I would like to take this opportunity to thank our teams for their hard work in caring for our patients."