A report published this week has identified the main defects at the much-delayed Royal Hospital for Children and Young People in Edinburgh designed by HLM
Many services will not now be available to patients until at least late 2020 after the report by NHS National Services Scotland (NSS) identified problems with the ventilation and water systems in the building.
In July this year Scottish health secretary Jeane Freeman postponed the hospital’s opening when safety checks revealed concerns about the ventilation system in the critical care department.
The Scottish Government then instructed NSS to undertake a detailed assessment of compliance of all building systems that could impact on patients and staff at the almost-complete hospital in little France. A second review was ordered into governance issues
Published on Wednesday, the NSS’s report identifies a range of issues that need to be resolved prior to occupation of the £150 million building, including ventilation and water systems. It is understood these will cost £16 million to rectify. Remedial work will be required in other parts of the building, with specific issues identified in the haematology/oncology department.
Though tests identified no widespread contamination of the water systems, the NSS recommends remedial and precautionary actions, as well as system-wide disinfection prior to occupation.
Meanwhile, the separate review by KPMG of the governance arrangements for the hospital found that the main issue with ventilation in the critical care unit stemmed from an error in a document produced by NHS Lothian at tender stage in 2012.
The report attributed this to human error and confusion over interpretation of standards and guidance. It also concluded that opportunities to spot and rectify the error were missed.
Freeman said: ‘I am, of course, bitterly disappointed that a mistake made in 2012 was not picked up earlier. This is a publicly funded project of strategic importance, which has not been delivered by NHS Lothian in compliance with the standards and guidance.
’The delay we now face will be borne by NHS Lothian staff, by patients and their families and the additional cost will be to the public purse.’
In response Scottish Labour health spokesperson Monica Lennon called for a public inquiry into the handling of the hospital build.
This project is a disaster
According to Holyrood magazine, she said: ’This project is a disaster; the statement throws up more questions than answers. We still don’t have a clear picture of where responsibility lies.’
‘Who from the Scottish Government sat on the project board and where are they now? On a principle of accountability, we need a full-blown public inquiry.’
Freeman ruled out an inquiry. However, the Scottish Government said that a senior programme director would take responsibility for day to day delivery of the RHCYP from now until the site is fully occupied.
It also confirmed that a new national body will be created to provide oversight of the design, planning, construction and maintenance of all major NHS Scotland infrastructure developments.
Report extract: NHS National Services Scotland – Review of: Water, Ventilation, Drainage and Plumbing Systems
Theatre ventilation was identified by NHS Lothian’s validation contractor as having some deficiencies. [We] visited the site with a specialist consultant engineer, who was lead author on the last three iterations of the ventilation HTM guidance.
This identified and confirmed several deficiencies, including lack of evidence about the efficacy of the ventilation in the scrub rooms; deviating from the standard models recommended in SHTM 03-01.
The current design of the theatre ventilation system is such that maintenance might entail loss of two theatres, rather than one. Additionally, there is an overuse of flexible ductwork, potentially causing problems with balancing theatre ventilation.
Earlier this year Tom Waterson, chair of Unison’s Scottish health committee, said he had spoken to senior NHS Lothian staff regarding drainage at the hospital.
He said at the time: ‘People are unable to confirm whether the drainage that has been put in is fit for purpose. We need to find out what’s happening before everyone moves in.’
Speaking to the BBC, Waterson claimed that problems with the building’s drainage had been identified as long as three years ago but contractors had pressed ahead.
He said: ‘There is a school of thought that they might have to rip it down. How do you fix drainage in a building when it’s x number of feet beneath the building? I’m not an engineer, but it’s not going to be easy.’
The new hospital had originally been scheduled to open in autumn 2017
Royal hospital for sick children, department of clinical neurosciences and child and adolescent mental health service mj richardson
Source: M J Richardson
Robin Webster, RIAS president
’The RIAS welcomes the move by Health Minister Jeane Freeman’s to hold an inquiry into the delivery of Scotland’s 2 hospitals. This follows our earlier support for inquiries into failures in Schools across Scotland and our continued involvement in these discussions. The removal of a co-ordinating overseer with professional independence; a broad and comprehensive understanding of the building design and the procurement process; with the time to apply that understanding and vitally, the executive authority to influence it, has inevitably allowed many gaps in the procurement process to open up; such that responsibilities are clouded, and appropriate resolution of issues fails to occur.’