The Queen Elizabeth University Hospital, which opened in 2015, was designed to meet the healthcare needs of the growing population of the city and surrounding areas. However, it has struggled to cope with the demand for services, resulting in long wait times for patients and a lack of available beds. I plan on explaining why.
It’s not working
Last month, only 35.1% of patients were seen within the allotted four hours at the hospital, and 1,179 patients waited longer than the target time. Since weekly recordings first started seven years ago, it was the lowest performance by any hospital in the country. The fault isn’t that of the staff or even the hospital itself, it’s a multitude of issues.
According to a statement from the Greater Glasgow and Clyde health board, the hospital was dealing with serious pressures, including issues throughout the entire facility that affected A&E. It claimed to be conducting a hiring drive and devising new patient care strategies, such as virtual A&E care. That’s great but it comes after letting a hundred or so staff go, or failing to renew their fixed-term contracts in favour of paying over the odds for more agency staff.
Just what are the issues? Well, I’ve worked in the NHS for over 16 years, all of those years at the same site, the Southern General Hospital and, of course, the Queen Elizabeth University Hospital, and I’d like to try and explain.
We need more people
There are several reasons why staffing is a problem for NHS Scotland. One of the main challenges is the high number of staff leaving the organisation. This can be due to various factors, including low pay, poor working conditions, and a lack of opportunities for career advancement. As a result, many experienced staff members are leaving the NHS, which can lead to a shortage of qualified personnel.
Another problem is the difficulty in attracting new staff. With the current economic climate and competition from other sectors, it can be difficult to attract talented individuals to work in the healthcare industry. Let’s not forget the damage caused by Brexit, either.
No doubt someone is angry with me right now, and they want to tell me that ‘Oh, but, NHS Scotland staff are better paid than those in England!’. Okay. Great. But I’m not in England, and neither are the patients.
The current pay and conditions can make filling vacancies and maintaining adequate staffing difficult. There was a recent positive step forward on this. However, members of two major NHS unions in Scotland voted this week to accept an improved pay offer from the Scottish Government. It’s not as much as we wanted, but it’s a hell of a start.
This matters as much for porters and domestics as it does for nurses and auxiliaries. I’ll give you an example…
Mary is in Accident and Emergency at 3pm and requires a bed in a ward, and luckily, there’s a bed in Ward 7A. However, there’s a problem, the bed hasn’t been cleaned as there are too few domestic staff. Okay, Mary is waiting a little longer, but the room will eventually be cleaned. Fast forward to 5 pm, and the room has now been cleaned, brilliant! However, we don’t have a porter to take Mary to the ward. Okay, it’s now 7 pm, and Mary is on her way to the ward. Not ideal, but not bad. Except, while Mary was delayed getting to her ward, a dozen more ambulances arrived, and they are waiting for Mary’s cubicle. The cycle starts again.
Community care provision is facing the same issues
One of the major problems at the hospital is the high number of patients who are ‘bed-blocking‘. This term refers to patients who are ready to be discharged but are unable to leave the hospital due to a lack of appropriate care facilities in the community.
This can happen for a variety of reasons, including a shortage of available care homes or a lack of support for patients who are returning to their own homes. As a result, these patients remain in hospital beds, taking up valuable space and resources. This contributes to the overcrowding in the accident and emergency department and makes it difficult for new patients to be seen in a timely manner.
The issue of bed blocking has been a longstanding problem for the NHS and has been the subject of much discussion and debate. In recent years, there have been efforts to address the problem, including the introduction of new policies and initiatives to support patients in their transition from hospital to home. However, the problem continues to persist and requires further action in order to ensure that patients are able to leave the hospital in a timely and appropriate manner.
The dreaded ‘Code Black’
The overcrowding in the accident and emergency department has also led to an increase in the number of ‘code black’ incidents. In NHS Scotland, a code black is declared when the hospital is experiencing a severe lack of available beds and is unable to admit any more patients. Imagine a ‘red alert’ on Star Trek, everyone is at battle stations dealing with the crisis but sometimes, resistance is futile.
When a code black is declared, it can have serious implications for both patients and hospital staff. Patients may be forced to wait longer to receive care, or may be treated in makeshift areas, such as corridors, which can compromise the quality of care they receive. Hospital staff can also be put under significant strain, as they are required to care for a larger number of patients than the hospital is designed to accommodate. It’s dangerous, it’s stressful and for most of the public, it’s invisible.
The crisis at the Queen Elizabeth University Hospital is a reflection of the wider challenges facing the NHS in Scotland. With an aging population and increasing rates of chronic illness, hospitals across the country are struggling to keep up with demand for services. It is important that urgent action is taken to address the lack of capacity and long waiting times in the accident and emergency department.
We have a problem, what’s the solution?
There are a number of measures that can be taken to prevent code black incidents at the Queen Elizabeth University Hospital in Glasgow. Some potential strategies include:
- Increasing the number of available beds. One of the main causes of code black incidents is a lack of available beds in the hospital. To prevent this, the hospital could consider increasing the number of beds, either by building additional wards or by converting existing space into additional beds, something already being considered.
- Improving the transition of patients from hospital to home. The health board could work with local authorities and community organisations to develop programmes and services that support patients in their transition from hospital to home. This could include providing additional care facilities and support services in the community.
- Providing additional resources and support to hospital staff. Having more staff can help to improve patient care by ensuring that there are enough qualified and trained individuals to provide care to patients. This can help to reduce wait times and improve the overall quality of care that patients receive. Additionally, having more staff can help to prevent burnout and improve job satisfaction among healthcare workers, which can lead to better retention rates and a more stable workforce. This one is simple, better pay equals more staff and better care.
By addressing the underlying causes of overcrowding and working to support patients and hospital staff, it is possible to prevent these incidents and ensure that patients receive the care they need in a timely and appropriate manner.
