Watchdog Raises Concerns Over Children’s Treatment in Adult Ward Due to Nurse Shortage

A healthcare oversight body has voiced apprehension regarding the placement of children in an adult ward at the primary hospital in the Western Isles, attributing this to an insufficient number of qualified nurses. Healthcare Improvement Scotland (HIS) reported occurrences where adult patients exhibited distress and aggression. HIS indicated that it had been informed that children were typically accompanied by staff, and attempts were made to move adult patients displaying confusion and aggression. However, HIS stated that NHS Western Isles admitted to instances where children were left without supervision, and provided inconsistent data regarding the number of personnel trained in paediatric support and the management of critically ill, worsening patients. The health authority announced that subsequent to the inspection, it had formulated a complete and extensive action plan for Western Isles Hospital located in Stornoway, Lewis. It further stated that it was implementing the necessary enhancements, addressing what it characterized as “unacceptably low” figures of staff who had completed current training. HIS conducted an unannounced inspection during September. The inspectors noted that staff were diligently working to deliver empathetic and attentive care. They also reported that patients expressed satisfaction with the care received, and the hospital premises were clean and properly kept. Nevertheless, HIS communicated with NHS Western Isles on two occasions during the inspection to highlight considerable worries regarding paediatric – children’s – care. These concerns pertained to the accessibility of nurses and the treatment of children within a section of an adult inpatient ward. In a published report, the oversight body stated: “We were advised that paediatric patients were accompanied by an adult at most times during their hospital stay.” It added: “However, NHS Western Isles acknowledged that there may be occasions when the paediatric patients are unaccompanied.” HIS further noted: “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.” However, HIS pointed out that no risk assessment was established to facilitate the transfer of patients exhibiting confusion and aggression. It also indicated an absence of certainty regarding the quantity of adequately trained personnel in paediatric immediate life support and for the systems and procedures for the secure care of severely unwell, worsening patients. Moreover, it reported not having received guarantees concerning staff training in multiple domains, such as child support and adherence to fire training. NHS Western Isles stated that it faced ongoing difficulties in its attempts to recruit registered children’s nurses, yet it had managed to raise its overall staffing level from four to five. It mentioned that a clinical support nurse was consistently available to assist staff, complemented by the 24-hour presence of a consultant paediatrician and a consultant anaesthetist. The health board confirmed that issues pertaining to fire safety were also under review. Chief executive Gordon Jamieson commented: “There are a number of points in the report that demonstrate the excellent care provided by our staff to the local population.” He added: “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.” Copyright 2024 BBC. All rights reserved. The BBC bears no responsibility for the content of external websites. Information regarding our approach to external linking is available.