Two patients sharing single rooms at Dumfries and Galloway NHS hospital operating over capacity, report says

Healthcare inspectors found that rooms designed to accommodate one patient at a hospital in Dumfries and Galloway were regularly used by two people at a time.

Healthcare Improvement Scotland (HIS) inspectors raised concerns about risk assessments and privacy for patients sharing single-occupancy rooms at Dumfries and Galloway Royal Infirmary.

When the single occupancy rooms were being used by two patients, some did not have privacy screens available, the report noted.

“In one ward where there was no screen available, we observed a patient being moved temporarily into the corridor by staff to allow the other patient privacy,” it said.

Concerns were also raised over the risk assessment carried out on patients in line to share a single occupancy room.

They found several different versions of the risk assessment, all with different criteria for the patients who could be considered.

The patients they spoke to agreed to being in a shared single-occupancy room but the risk assessment did not include a question on consent.

Senior managers later told the inspectors that additional screens were being ordered.

During the unannounced visit, which took place between March 20 and March 22, inspectors also found that the hospital was operating at more than 100% occupancy.

The report also praised senior managers and staff teamwork in delivering care, adding that despite the hospital operating over capacity, most areas were calm and interactions between patients, staff and relatives were positive.

Of seven requirements made by inspectors, two related to the additional patients in single-occupancy rooms.

They also made one recommendation and highlighted five areas of good practice.

Speaking of the report, Donna Maclean, chief inspector at HIS said that “like much of NHS Scotland, (the hospital) was experiencing a significant range of pressures”.

She added: “Despite the hospital being busy, the majority of areas were calm and well organised and we observed positive, respectful interactions between staff, patients and relatives with good teamwork to support the safe delivery of care. Senior managers displayed good oversight and understanding of their clinical areas.

“Facilities for patients and visitors were of a high standard, including an open concourse where patients could access outdoor walks.

“We raised a concern about the use of closed circuit television within a patient area and hospital managers responded quickly to this and took appropriate action.

“Other areas for improvement identified during this inspection include ensuring risk and fire safety assessments and evacuation plans for the use of contingency beds and non-standard care areas.”

A spokesperson for NHS Dumfries and Galloway said: “We welcome the findings of the Healthcare Improvement Scotland unannounced inspection, which are generally positive but do obviously bring with them welcome thoughts for how performance can continue to improve.

“In respect to the use of rooms, shared wards is not a new model but rather one which is still routinely employed locally and nationally.

“During surge planning it had been identified that there was sufficient capacity within these rooms to accommodate more than one patient in line with required standards.

“A very robust and well developed surge plan had been developed, and the report recognises these policy documents and that all rooms have been operating in line with these plans – including access to alarms, oxygen and electrical points and ensuite facilities

“We do recognise that privacy has been an occasional issue, and one that we have worked to address along with ensuring that all patients in these circumstances absolutely meet the required criteria.”