Child patients in adult ward due to nurse shortage

A healthcare watchdog has raised concerns about children being treated in an adult ward at the largest hospital in the Western Isles due to a shortage of trained nurses.

Healthcare Improvement Scotland (HIS) said there were incidents when adult patients could become distressed and aggressive.

It said it was told children were accompanied by staff most of the time, and efforts were made to relocate adult patients showing signs of confusion and aggression.

But HIS said NHS Western Isles conceded there were times children were left unaccompanied, and had given conflicting information on numbers of staff trained in paediatric support and the care of acutely unwell, deteriorating patients.

The health board said that following the inspection it had developed a full and comprehensive action plan for Western Isles Hospital in Stornoway, Lewis.

It said it was working on the required improvements, including what it described as "unacceptably low" numbers of staff who had completed up-to-date training.

HIS carried out an unannounced inspection in September.

Inspectors said they observed staff working hard to provide compassionate and responsive care.

They said patients were complimentary about the care provided, and the hospital environment was clean and well maintained.

But HIS twice wrote to NHS Western Isles during the inspection to raise significant concerns about paediatric - children's - care.

The concerns related to the availability of nurses and children being treated in an area of an adult inpatients ward.

In a report, the watchdog said: "We were advised that paediatric patients were accompanied by an adult at most times during their hospital stay.

"However, NHS Western Isles acknowledged that there may be occasions when the paediatric patients are unaccompanied."

Fire training

HIS added: "Hospital managers advised that where an adult patient becomes confused and shows signs of aggression, they would look to relocate them to another ward to ensure paediatric patients are not cared for within the same area."

But it said there was no risk assessment in place to support the movement of patients displaying signs of confusion and aggression.

It also said there was a lack of assurance on numbers of suitably trained staff in paediatric immediate life support and for systems and processes for the safe care of very unwell, deteriorating patients.

It further said it had not received assurances on staff training in several areas, including child support and fire training compliance.

NHS Western Isles said it was consistently being challenged in its efforts to recruit registered children's nurses, but had successfully increased its total complement from four to five.

It said a clinical support nurse was always on duty to support staff, along with 24-hour availability of a consultant paediatrician and consultant anaesthetist.

The health board said concerns around fire safety were also being addressed.

Chief executive Gordon Jamieson said: "There are a number of points in the report that demonstrate the excellent care provided by our staff to the local population.

"It is testament to the staff delivering care that all patients spoke highly of the care received and would be happy if a loved one had to access care at Western Isles Hospital."