Inspectors raised “serious concerns” over the running of an emergency department in a hospital last year, it has emerged.
Healthcare Improvement Scotland (HIS) wrote to NHS Grampian to highlight a number of concerns following an unannounced two-day inspection of Dr Gray’s Hospital in Elgin, Moray, in October.
In its summary of its assessment of the facility published on Thursday, HIS said its concerns included the management of controlled drugs within its emergency department.
HIS said other concerns involved oversight and management of incident reporting systems, and the availability of staff training for providing life support to minors.
The summary said: “We observed staff providing compassionate and responsive care, with most patients being complimentary about the care provided.
“However, as a result of serious concerns identified during our inspection, we wrote to NHS Grampian on two occasions.
“We raised concerns about the management of controlled drugs within the emergency department. We also raised concerns regarding the oversight and management of the incident reporting systems and processes impacting on patient safety, dignity and respect at Dr Gray’s Hospital.
“During our inspection we observed evidence of failures to review, action and close incidents reports relating to patient safety, privacy and dignity, and staff concerns around workload and culture, particularly in the emergency department.
“We are not assured of senior management oversight of possible and reported risk to patients and staff, especially in the emergency department.
“Staff described a culture where they were encouraged to raise concerns. However, they did not feel that these were always listened to by senior managers.
“We have concerns about the availability of staff training in paediatric immediate life support and systems and processes for patient triage in the emergency department.
“Increased capacity and pressures within the emergency department has had an impact on patient privacy and dignity.
We've published our latest inspection reports for Aberdeen Royal Infirmary and Dr Gray's Hospital, NHS Grampian.
Links are in the comments to read the reports. pic.twitter.com/XDo73iAKPd
— Healthcare Improvement Scotland (@online_his) February 1, 2024
“Other areas for improvement have been identified at Dr Gray’s Hospital. These include the safe storage of medication and of cleaning products and the completion of patient documentation.”
Professor Duff Bruce, clinical director at Dr Gray’s, said in response to the findings: “We completely accept that we don’t always get it right, and on the occasions where care wasn’t at the high standard our patients expect, I’d like to apologise and offer people my assurance that we have a comprehensive action plan in place to ensure that we learn from and avoid these types of issues in the future.
“While we always prioritise individual patient care, we recognise the importance of appropriate administration and record keeping and are already implementing new measures to build on our existing policies.”
HIS also carried out an unannounced assessment of Aberdeen Royal Infirmary last October which resulted in a number of areas for improvement being identified.
These included modifications relating to the management of peripheral venous cannulas, non–standard care areas and the safe storage of medication and of cleaning products.
A summary of the inspection also published on Thursday said: “At the time of inspection, Aberdeen Royal Infirmary, like much of NHS Scotland, was experiencing a significant range of pressures including increased hospital admissions.
“Increased hospital capacity meant patients were being cared for in additional beds in non-standard patient areas such as treatment rooms or corridor spaces.
“This impacted on the ward environment, staff workload and patient experience of care.
“Despite these pressures, we observed that staff were focused on the provision of safe and compassionate care.
“Wards were well managed with clear leadership and effective communication. Patients we spoke with described good care and we observed staff treating patients with respect, dignity, and compassion.
Dr June Brown, NHS Grampian’s executive nurse director, said in response to the findings: “We have a proven record of working constructively with HIS colleagues and were able to resolve some of the things brought to our attention during their visit.
“However, we know we’ve more to do and are using the report to direct our focus.
“Where patient care wasn’t as we would have expected, I would take this opportunity to apologise to patients and assure them that we have a comprehensive action plan for improvement.”