Deaths linked to staffing issues at Queen Elizabeth University Hospital



STAFF shortages may have contributed to two deaths in a single four-week period at a flagship Scottish hospital, an investigation has found. 

Both patients died at the Queen Elizabeth University Hospital (QEUH) in Glasgow earlier this year.

The revelations come ahead of the warning last week by a senior doctor
that Scotland’s NHS is in “a perilous situation” amid a staffing and funding crisis.

Health Secretary Humza Yousaf said last Sunday that the NHS was facing “its most challenging winter yet” because of the legacy of the pandemic, tighter budgets and reducing staffing, and that it would take “at least five years” to fix.

Official figures show about 6,000 nursing and midwifery posts are unfilled across the service while A&E waiting-time targets continue to be missed.

Dr Iain Kennedy, chairman of the doctors’ trade union the British Medical Association, who delivered the warning over the “perilous situation” facing the service said last week some 15 per cent of hospital consultants’ posts were vacant. 

The staffing issues relating to two deaths at the QEUH were revealed in response to a Freedom of Information request.

A Datix incident reporting system report obtained under FOI by Scottish Labour which had asked for incidents related to “staffing or an inappropriate skill mix” showed a total of 336 incidents  in NHS Greater Glasgow and Clyde between July 18 and August 18, 2022.

These included 59 “near misses” recorded across the health board, and 14 incidents causing illness or injury – 10 of which were at the QEUH. 

‘Tragic figures’
Scottish Labour public health spokesman Paul O’Kane said: “These tragic figures lay bare the cost of the workforce crisis engulfing our NHS. 

“Lives have been lost, patients have been hurt, and dozens more catastrophes were narrowly avoided.

“NHS workforce is overstretched and undervalued, and these terrifying figures are a glimpse of what will happen on a larger scale if the Scottish Government’s negligence continues.

“Our worst fears are already being realised, and things will only get worse as we head into winter. Hardworking NHS staff are being put in these impossible positions because of the SNP Government’s failure. Humza Yousaf must act now before winter begins.”

Mr Yousaf, who was branded by Scottish Labour in a Scottish Parliament debate last month as the worst health secretary since devolution, told BBC Scotland’s Sunday Show he hoped the public would understand the reasons that the NHS was under “such significant pressure”.

“It is not performing at the level that any of us would like, that is stating the obvious,” said Mr Yousaf, who this month announced that £600 million would be provided in the coming months to shore up health. 

He said: “It will take years. It isn’t going to happen in the course of winter. Our recovery plan is over the course of five years, because this is going to take at least five years. This winter itself is going to be the most challenging the NHS has ever faced.”

Reasons included the lingering effects of the pandemic but also the high levels of delayed discharge of patients fit to leave hospital.

“One of the biggest problems in our hospitals is the high level of delayed discharge,” Mr Yousaf said.

“Eighteen hundred people who are clinically safe cannot get out because local authorities are unable to provide social care, either at home or care home places.”

He said social care had been hit by “a triple whammy” of Brexit – causing staff shortages – the pandemic and high energy and inflation costs, creating a “tough business model” for care home operators.

£400m cuts
DEPUTY First Minister John Swinney unveiled cuts worth £400m to the health and social care budget on Wednesday as part of £615m raft of public spending savings in addition to cuts announced in September of more than £560m.

The review of the in-year budget was due within two weeks of the “mini-Budget” in Westminster, which ultimately cost Liz Truss her job as Prime Minister, but was twice delayed. The announcement meant £1.2 billion has been cut from the Scottish budget in two months.

Mr Swinney blamed the “severe financial mismanagement” by the UK Government, saying “calamity is giving way to austerity” ahead of the Autumn Statement on November 17. He also pointed to “extraordinary pressures from inflation” which he said had forced the Government’s hand.

The £400m reprioritised from the health budget includes £118m in cuts to Covid-19 spending on vaccination, Test and Protect, and PPE, as well as £70m from social care and the development of the heavily-criticised National Care Service plans.

A further £85m has been raided from primary care services, including delays to community optometry and audiology services, with an additional £83m cut from the Scottish Trauma Network and improvement programmes.

NHS pressures

RESPONDING to revelations that staffing issues contributed to two deaths in July and August at the QEUH, Mr Yousaf underlined the pressures the service was under.

“Our thoughts are with anyone who has suffered the loss of a loved one while in our care. The health service is facing a triple threat this winter – recovering from the worst effects of the pandemic, high energy costs and rising inflation, and the loss of much-needed staff due to Brexit,” he said.

“Like health services across the UK and globally, we expect this winter to be one of the most difficult NHS Scotland has faced.Through our £600m health and care plan we are recruiting 1,000 new NHS staff, including up to 750 nurses, midwives and allied health professionals from overseas. 

“A key focus of our £600m winter plan is on social care and actions to encourage integration authorities to help alleviate delays. We continue to take positive action to promote patient safety, and just last month we introduced the Patient Safety Commissioner for Scotland Bill to Parliament.

“This legislation will further strengthen the patient voice within the healthcare system and take action to promote patient safety across our healthcare system as a whole.”

A spokesman for NHS Greater Glasgow and Clyde said: “We would like to extend our sympathy to families who have lost a loved one in our hospitals.

“Staff members are encouraged to report incidents, including staffing issues, on the Datix incident reporting system.

“However, an issue may be resolved quickly and the Datix report is not updated to show this. Therefore, while the Datix reports are a useful record of concerns about staffing, they may not give an entirely accurate picture of the situation.
“Investigations into the circumstances surrounding the two deaths are ongoing. However, we cannot comment further due to patient confidentiality.”

Serious concern
SPEAKING after Mr Swinney’s statement, Dr Lailah Peel, deputy chair of BMA Scotland, said: “The whole of healthcare is under huge pressure so any area which is deprioritised will be a cause for serious concern as some of these services are close to collapse, not least due to lack of staffing.

“We must continue to invest in staff and all frontline services if we are to avoid the situation becoming more precarious than it already is.

“Funding being cut in social care is particularly concerning – without adequate social care facilities in place, it is difficult to safely get patients, who require social care, out of hospital.

“As it stands we are already seeing the significant impact this issue is currently having on patients because of the poor flow through our hospitals and it is no exaggeration to say patients are coming to harm as a result.

“If we cannot get patients out of the back door, we cannot get them through the front door – the knock-on effect of social care struggling has huge implications for the wider health and care system.

“We are also seeing more patients presenting with mental health issues since the pandemic and cuts to a service which is already on its knees could be hugely damaging to the care that can be provided, given it is pretty much already stretched to the limit.”

The Scottish LibDems also highlighted £38m cut to mental health services, with party leader Alex Cole-Hamilton labelling that decision as “manifestly wrong”.

 





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Glasgow University academic on why he took a stand against sexism


Four years ago Dr James Going was told he had an untreatable cancer with months to live.

He spent the next few days trying to come to terms with his prognosis but on the fifth day he received a call to say further tests had revealed he was suffering from an aggressive lymphoma that was likely to respond well to chemotherapy and radiotherapy.

The experience, he says, “opened his eyes to things to which I had been blind” including the discrimination he says women are continuing to experience in major institutions.

Last week the University of Glasgow issued an apology to staff and students after an inquiry identified “sexist and discriminatory” behaviour within the medical school.

Professor Matthew Walters, head of the School of Medicine, Dentistry and Nursing said an action plan was being drawn up following, “unacceptable and distressing incidents”.

Dr Going resigned from his teaching post a week earlier saying a “culture of misogyny was flourishing” within the institution. 

The university responded saying his contract to teach as an associate clinical professor had ended last year.

HeraldScotland:

In fact, he had been continuing to teach third year medical students until October 14.

“It was quite obvious that the university had no intention of doing anything about this,” said Dr Going, “and I could see very clearly what a detrimental effect it was having on people I life and respect.

“I would say the university’s position on this has been, let’s pretend nothing is happening and it will all go away.

“I think they have been completely spineless.

READ MORE: Senior academic at centre of gendered bullying probe to leave university 

“This is not just an idle hobby for my declining years, it’s a passionate belief that women are frequently unfairly treated in major organisations.

“The haematologist who kept me alive is a woman, the radiotherapist who planned and directed by radiotherapy was a woman.

“It is an outrage that women in 2022 are still being treated as second class.”

Dr Going, who is a pathologist at Glasgow’s Queen Elizabeth University Hospital, says he first raised concerns about the treatment of female staff within the medical faculty in December last year. 

HeraldScotland:

He said: “That’s nearly a year ago. I wrote a letter about one of the people who has been very adversely affected by these behaviours.

“It was the usual, ‘we take these matters very seriously and everything is being done that should be done.’”

A grievance lodged by staff about the conduct of Professor John Paul Leach, head of undergraduate medicine, was upheld by the university but was later appealed.

Prof Leach, told The Herald that a subsequent inquiry found “there was no case to answer”. It was announced last week he is to leave his post within weeks. Medical students said to have found this out in media reports. 

READ MORE: University leaders ‘sorry’ for distressing sexism 

The women involved in the grievance were told the content must remain confidential.

Dr Going has his own views on culpability but does not want to compromise the staff who were affected.

HeraldScotland:

He said: “They [the university] said something which is frankly ridiculous, which is, that they have had an investigation into this and the inquiry has found that no individual was culpable.

“Yet, we are very very sorry.

“It’s a wonderfully ambiguous piece of formulation because it could mean nobody has been responsible or it is just as likely to mean, that multiple people have been responsible.

“There are different kinds of complicity in this sort of thing,he said.

“There are the key people who behave in this way and my feeling is they behave this way because it’s the way they are wired up mentally.

“The problem is, they are surrounded by others who should be saying, ‘that behaviour is not acceptable’.

“You’ve got people [within the university] who have got that power.”

READ MORE: Glasgow medical student was told she ‘should do a secretarial course’

The university has said a new oversight group is being set up to devise an action plan which will make improvements “where necessary” with enhanced training for staff.

“They don’t need more policies,” said Dr Going who lives in Giffnock. “They don’t need more committees but what they do need is people in senior management positions to actually do the job, which would be to not put up with behaviours that should not be put up with.

“I’m sorry to say this because I had the pleasure of working with some marvellous people but I also had the less pleasurable experience of watching some very questionable people flourishing because they were allowed to.

“I just feel that the university has learned nothing from a whole bunch of negative experiences that other organisations have gone through where essentially they have covered up bad behaviour.

“Eventually it does get out.
“I’ve got a daughter, I’ve got a granddaughter – the idea that they will come across this…I’m not going to stand by.”

Prof Matthew Walters, Head of the School of Medicine, Dentistry & Nursing at the University of Glasgow, said: “The wellbeing of everyone in our community will always be our prime concern, and we are committed to ensuring that all staff and students in the University and its Medical School feel safe, supported and free from discrimination or abuse of any kind.

“Following concerns over gender-based bullying and discrimination within the Undergraduate Medical School we launched an internal investigation. While no individuals were found culpable, behaviours were uncovered that fell short of our high professional expectations.”





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Scotland could regain ‘UK public health leader’ crown says new charity head


Scotland could once again emerge as a UK leader in public health if it emulates ‘world-first’ smoking laws in New Zealand, according to the new leader of a national charity.

A ban on smoking in public places came into force In Spring 2006, under the Labour-run Scottish Executive and the rest of the UK followed.

Research shows the number of heart attacks fell by 74% from 1990 and 2014 in Scotland. Reductions in the numbers smoking along with increased uptake of cholesterol testing and statin drugs were cited as major contributory factors.

David McColgan, the new leader of British Heart Foundation Scotland, said he believes there is “an appetite” with the SNP administration to push smoking laws further.

HeraldScotland:

In July New Zealand legislators vowed to break the “disgusting and bizarre” hold of cigarette companies, introducing world-first legislation that will stop the next generation from ever being able to legally buy cigarettes.

The government has introduced its new laws to try to create a smoke-free generation, installing a steadily rising purchasing age so that teenagers will never be able to legally purchase cigarettes.

READ MORE: Smoking ban credited for 74% drop in heart attacks in Scotland 

The rules target only tobacco products, and vaping will remain legal.

Coronary heart disease is still the number one killer in Scotland. Cigarette smokers are 2 to 4 times more likely to get heart disease than non-smokers.

While overall smoking rates have declined in Scotland, differences by deprivation have increased, with rates highest in the most deprived areas, highlighting that smoking remains an ongoing health inequality challenge.

Mr McColgan said Maree Todd, Minister for Public Health, was “really passionate” about the issue.

Earlier his year her husband John, a previously fit and healthy 48-year-old, had a heart attack and was given clot-busting drugs in the back of an ambulance en route to Raigmore hospital in Inverness.

“If we could get everyone to stop smoking today, heart disease rates would plummet, so would cancer and a whole range of things,” said Mr McColgan, who is also the chair of ASH Scotland.

“There is new tobacco strategy being developed at the minute. 
“We’ve seen a lot of exciting developments around tobacco and New Zealand is leading the way.

“The three measures they are looking at are taking nicotine out of cigarettes and they want to go from something like 5000  tobacco retailers to 900.

“They are also looking at incremental age so every year they are going to increase the age of sale so theoretically people born on a certain date will never be able to buy cigarettes.”

READ MORE: £400 incentive doubled smoking quit rate in Scotland 

Asked if Scotland could follow their lead he said: “I think the Scottish Government has got a strong record in tobacco control and I think there is an appetite there to be that public health nation again.

“Maree Todd is really passionate about this. There is great work out there that can evolve in Scotland.”

The Irish government introduced the first national comprehensive legislation banning smoking in all workplaces, including bars and restaurants in on March 29, 2004.

Mr McColgan said Scotland was already a step ahead of England in driving forward legislation to ban junk food price promotions such as two-for-one offers by Spring next year.

“Boris Johnson committed to price promotion legislation which has been silently pushed to the side,” he said.

“I kind of feel that we in a really positive place with a minister like Maree Todd.”

A major piece of work by the government to establish which areas of Scotland are under-performing in heart disease diagnostics and treatments will publish its findings in the New Year.

READ MORE: Five myths about quitting smoking as research shows 40% of cancers could be prevented

“In Scotland, data collection is standard but there is no national picture of heart disease,” said Mr McColgan, who will take over the role as head of the charity on November 14.

“We can’t tell you whether the service is better in one health board versus another. It’s very patchy.

“We know from speaking to patients that some are waiting longer for procedures or diagnostics but across the board we don’t have that data and that’s probably the biggest concern in Scotland.

“If we have that data picture we would be much better able to direct cash.

“They did an exercise like this in cancer and it was instrumental in helping tackle health boards that were under-performing and pull funding into those areas.”

National funding for a heart disease action plan remains a concern, he says.

“They invested £2.2million in the initial stages of the plan which doesn’t buy you much. Much of that has gone on the data collection project, which is vital and needed to be done.

“Coronary heart disease is still the biggest killer in Scotland yet the funding received to provide a world-class service is massively shadowed by cancer.

“There is a mature conversation to be had about the burden of disease.”

Emergency care for heart attacks in Scotland is good, he says, despite the challenges facing the NHS.

He said: “By and large we are doing a pretty good job. The biggest challenge is discharge at the other side.”

He said that while patients had not been able to get in front of clinicians so much during Covid, in some ways the shift to digital care had been positive.

“There’s been a lot of innovation. BHF launched a cardiac rehab at home programme.

“The big challenge in that though is if you are not confident in digital technology or you don’t have access to it.

“The most important thing in this is not to compound inequalities”


 





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