Scottish Hospitals Inquiry

By Bill Heaney

The judge-led Scottish Hospitals Inquiry is moving towards stage 4 of the Glasgow hearings in relation the Queen Elizabeth University Hospital and Royal Children’s Hospital, which treat patients from West Dunbartonshire and Argyll and Bute. 

During this part of the hearing, the Inquiry took evidence from five groups of witnesses:

• Estates staff of NHS Greater Glasgow and Clyde and contractors involved in the construction and commissioning of the project.
• Clinicians, including those involved in Infection Prevention and Control (IPC).
• Communications.
• The expert panel of the 2021 Case Notes Review.
• The panel of independent experts appointed by the Inquiry.

The hearing presided over by Lord Brodie, examined the extent that non-compliance with relevant regulations and guidance led to ventilation and water contamination issues at the Glasgow hospital. It also explored the actions taken to resolve these issues after the handover in 2015 and the extent of their effectiveness.

The Glasgow stage 4 hearing session will begin on 29 April 2025, in which all remaining evidence necessary for the Inquiry to address its remit and terms of reference will be heard.

There will also be an oral hearing to hear final closing submissions in relation to the Queen Elizabeth University Hospital and Royal Hospital for Children in August.

Eventually opening in March 2021 with the delay believed to have cost almost £17 million, the hospital became a subject of the Scottish Hospitals Inquiry – alongside parts of the Queen Elizabeth University Hospital campus in Glasgow .

Lord Brodie, chairman of the inquiry, published 11 recommendations on Monday as part of his interim report, where he criticised NHS Lothian’s handling of the design of the RHCYP and accused it of leaving patients and families “in the dark” on the delay.

Lord Brodie, left, said: “On the basis of the evidence that I have heard, I have concluded that in a project for the construction or refurbishment of a healthcare facility, it is the health board, as the prospective provider of that healthcare, in consultation with relevant stakeholders and clinical and technical advisers, that is best-placed to identify what it requires from the ventilation system.

“Accordingly, determining the output parameters of a ventilation system should not be left to the judgment of the project company and its subcontractors during the design phase.

“The design should address how previously determined parameters are to be achieved, not what should be achieved.

“In relation to this project, it is my conclusion that NHS Lothian did not present its requirements for the output specifications of the ventilation system with sufficient clarity and precision.”

The matrix contained an “undetected error” in relation to critical care rooms, the inquiry said.

Jim Crombie , the deputy chief executive of NHS Lothian, said: “Lord Brodie has identified our failure to provide a clear design brief at the outset as critical to events as well as weaknesses in governance and understanding between contractual partners.

“We are sorry for these failures and also deeply regret that opportunities were missed by all parties over the course of the project to detect and rectify errors in the design of the ventilation regime.

“The report acknowledges the changes that have been put in place in NHS Lothian and the new guidance introduced since 2019 to ensure that lessons are learned and similar events can be prevented in the future.

As well as the design of the buildings, the inquiry also criticised NHS Lothian’s handling of communications with patients and their families around the delay.

“The decision not to open the hospital as planned had a significant impact on patients and their families, who were shocked, scared and deeply disappointed that long-promised new facilities were not to be available for the treatment, in some cases, of children suffering from very serious conditions,” Lord Brodie said.

“Patients and their families were left in the dark as to the reasons why the hospital did not open as planned.

“Communication with patients and families was unsatisfactory in this regard. I have seen this to have been important.

“There is a group of young patients who are very seriously ill and spend a significant portion of their time, sometimes much of their lives, in hospital.

“They are supported by family members or guardians. The hospital becomes, for them, their second home.

“The impact of unclear or poor communication on the wellbeing of patients and their families during what may already be a very difficult, emotional and uncertain period in their lives is significant.”

Mr Crombie responded: “Patient safety was always our driving force in commissioning a first-class hospital building so we know that the discovery of a ventilation problem just days before it was due to open caused shock and significant concern for our patients, their families and our staff.

“We once again reiterate our sincere and unreserved apology to them all for the resulting delay to the transfer of patient services to the new facility.

“I am particularly sorry that patients and their families were let down at a time when they were already worried and vulnerable.”

The final report of the inquiry, which will focus on the Glasgow hospital, is expected next year.

Meanwhile, politicians have commented on the inquiry report.

Jackie Baillie, Scottish Labour’s Health spokesperson, right,said: “This interim report is the first glimpse of the catalogue of failures in the construction of two of our newest hospitals in Scotland.

“The report has revealed a worrying complacency by the SNP government and NHS Lothian when it comes to crucial details of hospital building projects.

“It also highlights how, when the fault in one hospital was discovered, the SNP government’s failure to communicate properly with patients led to unnecessary disruption and distress.

“The SNP government must learn the lessons of this report so such mistakes are never repeated and taxpayers’ money is not wasted again.”

Responding to the interim findings in relation to the Inquiry’s Edinburgh investigations, Scottish Liberal Democrat leader Alex Cole-Hamilton MSP, left,  said:  “My constituents were deeply worried by the delays and confusion relating to the opening of the new children’s hospital in Edinburgh.

“For many patients and their parents it was an extra layer of stress that they should not have had to deal with at an already difficult time.

“It was also another unnecessary expense for taxpayers to bear.

“There are a number of Scottish hospitals requiring renewal or replacement in the coming years including the Belford in Fort William and the Gilbert Bain in Shetland and it will be important that their construction is informed by these findings.”