PATIENTS are staying overnight in what is known as the “immediate assessment unit” of Scotland’s new multi-million pound hospital because of bed shortages.

Most mornings “significant numbers of patients” who arrived the previous day are said to be waking up in the unit at the Queen Elizabeth University Hospital because there is no space to move them onto the appropriate wards.

Sources say there have also been difficulties recruiting acute medicine specialists to help man the unit, with staff from other hospital departments providing the cover it needs.

A source said: “Most days start with significant numbers of patients from the previous day still waiting for a bed.”

Capacity in the unit, which takes patients referred to the Queen Elizabeth by GPs, has already been expanded since the new hospital opened last May.

The extra cubicles were announced in the Scottish Parliament before Christmas after an elderly patient died on a trolley in the department, sparking a review.

Dr John Ip, a Paisley GP, said the unit had reached a "crisis point" and a team was pulled together at that time to help find solutions.

"People were waiting hours and hours on trolleys," he said. "These are frail, elderly people."

Figures, obtained by The Herald, show during the first five months of operation almost 3000 patients were kept in the unit for more than 12 hours. Between June and October last year – before the winter which increased pressure further on the hospital – 2973 patients spent more than 12 hours in the unit. A further 1637 spent more than eight hours there.

Unlike accident and emergency departments, which are subject to stringent four hour waiting times targets, there are no set goals for the time patients wait in Scottish hospital units which accept patients referred in by GPs.

It is thought appropriate for some patients, who may not need to be admitted to hospital wards, to spend some time in these units while tests are carried out and treatment has time to work.

However, Dr Ip said often patients were waiting on trolleys and could be deteriorating or in pain.

The Herald asked health board NHS Greater Glasgow and Clyde to visit the unit or discuss the waiting times figures with staff. After months of delay the board said "we have faced challenges with our performance which has fluctuated weekly. With this in mind the staff at the unit do not feel this is the right time to sit down with you."

NHS GGC has admitted before that the unit was seeing significantly more patients than predicted.

It is thought more patients are being referred to the £842m hospital, which opened last May, than expected – perhaps because of the draw of a new building. A lack of capacity on the main hospital wards is also said to be making it difficult to get patients moved out of the immediate assessment unit and onto the right ward for their condition.

Dr Ip questioned whether the capacity of the building had been future-proofed when it was designed.

Saying the problems had not yet been fully resolved, he said: "This hospital is going to be there for 50 to 60 years at least. We need to make it work. We do not have the funds to build a new hospital."

In a statement NHS GGC said: "The immediate assessment units are not emergency departments. They are part of a hospital admissions unit where patients come in for a series of tests and assessments to determine if they need to be admitted for a longer stay in hospital or whether they can go home with appropriate support. Patients can therefore be expected to stay for longer than 12 hours in the unit."

According to the board four out of 10 patients treated in the IAU are sent home rather than admitted.

NHS GGC added that they are looking at setting up a system for monitoring the performance of IAUs across all their major hospitals.

Dr Alistair Douglas, consultant at Ninewells Hospital and past president of the Society for Acute Medicine, said to be safe and effective medical admitting units needed dedicated acute medicine staff and a flow of patients through the hospital. He added: "Pressures are felt through-out all hospitals in Scotland particularly in winter and are a challenge to us.

"It is about avoiding unnecessary delays in the hospital system including discharges and social care. Those of us working at the front door are often working flat out to the maximum of their ability but are thwarted when there is not (bed) availability to go to the specialist wards in the hospital."