Portakabin hospital ward delayed over safety fears

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modular hospitalImage source, NHS Forth Valley
Image caption,

The modular buildings for the new hospital ward are being supplied by the firm Portakabin

A new hospital ward has been delayed after NHS trouble-shooters found problems with the construction project which could compromise patient safety.

The 30-bed ward at Forth Valley Royal Hospital is part of a new National Treatment Centre (NTC) aimed at increasing capacity for operations.

But a review by NHS Scotland Assure found ventilation, fire safety and flooding concerns with the project.

NHS Forth Valley said it was making good progress on addressing the issues.

It comes in the wake of fierce criticism of the health board in an independent review., external

The Forth Valley NTC, part of a nationwide plan to reduce a backlog of knee and hip operations, was originally scheduled to open last year.

Work eventually started in June 2022 but the project has faced further delays.

And last month construction watchdog NHS Assure said it could not support it going forward without changes.

Its inspectors found two significant and 19 major issues with the project, including a lack of detail within the fire strategy, non-compliance with some NHS guidance and a lack of detail on pre-commissioning checks.

NHS Assure - set up to monitor the quality, safety and running of health board construction projects - concluded if the issues were not addressed they could "potentially compromise the safety of patients and staff".

An issue with water getting into the site that resulted in damage and mould growth on internal walls was also spotted during one of the inspections by NHS Assure.

Without a satisfactory NHS Assure review, new health facilities are not allowed to open to the public.

The watchdog also said that it was "of significance" that it did not have assurance many of the issues raised during a previous inspection of the NTC ward - which found 42 areas of significant or major concern - had been addressed satisfactorily.

Image source, NHS Forth Valley
Image caption,

An computer generated image of what the new modular ward at Forth Valley Royal Hospital will look like when completed

The facilities at Forth Valley Royal Hospital will be part of a network of NTCs across Scotland which are meant to be delivering at least 40,000 additional procedures per year by 2026.

However, many of these centres are facing cost overruns and delays.

When the new ward opens, all of its patients will be from other health boards with longer orthopaedic waiting times than NHS Forth Valley.

It will not be open to local patients until "waiting times across Scotland are equalised", according to the NHS Assure report.

'Good progress'

This decision by the Scottish government, which it said reflected the waiting time pressures brought about by the Covid pandemic, is a departure from the original plan for the facility.

It would have resulted in 50% of its capacity being allocated to other health boards and the rest to NHS Forth Valley.

A spokeswoman for NHS Forth Valley said: "We have made good progress in resolving a number of the issues highlighted in this report and continue to work closely with NHS Assure to resolve any outstanding issues or concerns.

"The aim is to have the new inpatient ward operational at the earliest opportunity and all parties are committed to this."

The spokeswoman added that patients from other health boards were already being treated for a range of specialities in the additional two operating theatres at Forth Valley Royal Hospital that have been built as part of the new NTC.

'Significant impact'

The Scottish government has had "oversight" of NHS Forth Valley since November last year in a bid to tackle problems with out-of-hours services and unscheduled care.

A new review of the health board's corporate governance found that poor working relationships between some executives and non-executive board members not doing their jobs properly has contributed to the NHS Forth Valley's problems.

It found: "The failure so far to resolve the issues around behaviours and relationships at executive leadership team have had a significant impact on both the organisational culture and the governance arrangements".

Some of the senior NHS officials interviewed told the report authors: "Without some changes to the leadership in the board and executive leadership team, they would continue to struggle and be unable to deliver the improvements required".

The senior level failings have contributed to the health board being unable to agree an appropriate model for the delivery of integrated health and social care services, the review found.

Improvements made

NHS Forth Valley said a wide range of changes and improvements had been made since the review was commissioned in January

It said a number of the recommendations highlighted in the report have already been addressed and any outstanding actions would be captured in its updated assurance and improvement plan.

It added: "Although good progress has been made in many areas, we recognise that there is still more to do and we are committed to listening and learning as we take forward work to further improve culture, governance and leadership across the organisation."