Give them the tools and they will do the job.
As The Herald revealed yesterday, potentially dirty, deficient and damaged surgical instruments have resulted in the postponement of a number of orthopaedic operations at Glasgow's Gartnavel hospital. It now appears that about 200 hip and knee replacements were cancelled at short notice earlier this year and some have yet to be rescheduled.
So patients like 85-year-old Helen Cullen of Milngavie face several extra weeks of pain and discomfort while they wait for another appointment. The source of the problem is the centralised NHS-run decontamination unit at Cowlairs, which replaced six smaller local units spread around the city's hospitals. This centralisation was intended to improve the quality and efficiency of the service in the wake of concern over the number of hospital acquired infections.
There seem to be two versions of this story. NHS Greater Glasgow and Clyde was quick to offer reassurance yesterday that the issue had been resolved. The board pointed out that 12 million items of equipment pass through the unit annually and "from time to time there will be isolated instances of damaged or incomplete packs" being delivered to operating theatres. The statement refers to "an ongoing enhanced Quality Assurance process".
However, NHS staff say the problem is a long-term one, associated with a high staff turnover at Cowlairs and a lack of training, especially when trainees speak poor English. Union officials speak of a "pressure cooker" atmosphere at the plant. There appears to have been a breakdown in trust in the system, with surgeons reluctant to put patients at risk.
If this is the case, it is totally unacceptable. It would be interesting to know if there has been a rise in post-operative infections as a result of this situation and whether other hospitals have been affected.
The situation also appears to be aggravated by an issue about damaged equipment awaiting authorisation for repair. The fact that this issue has been building up for some time suggests there is a real problem at NHS Glasgow and Clyde with whistleblowing. There is something wrong with the management style if staff feel constrained from voicing their safety concerns.
Could pressure to meet waiting times be a factor here? It is worrying that staff are reluctant to complain when things go wrong and highly trained surgeons have to make late adjustments to their patient lists. Good progress has been made in tackling hospital acquired infections. It would be tragic if such progress was to be jeopardised by a weak link in the system.
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