THE Scottish Government's health watchdog is to begin a programme of unannounced swoops on hospitals to address concerns over the treatment of elderly and infirm patients.
Health Improvement Scotland (HIS), which was set up last year, will make the spot-checks to assess factors including nutrition, dementia care and the level of dignity and respect afforded to older people in hospitals across the country.
The news comes after Glasgow Royal Infirmary was the subject of a damning report earlier this week which highlighted problems with privacy and said some patients had not been assessed for dementia or checked for pressure sores. Patients with walking frames had been unable to use the toilets on some wards and bathing and showering facilities were limited, it said.
HIS has carried out several such inspections since it was launched last summer, but all its hospital visits so far have been announced, with hospitals given four weeks' warning that chief inspector Susan Brimelow and her team were coming.
Although HIS was given the power to inspect without warning when it was set up by Health Secretary Nicola Sturgeon last year, it has yet to use it.
However, Ms Brimelow has revealed that the first unannounced inspection will take place next month, with subsequent hospital checks taking the form of a mixture of announced and unannounced visits.
Speaking to The Herald, she said: "I believe hospitals should be ready for inspection at any time. I would rather that hospitals focus on improvements for patients, rather than being prepared for inspections.
"As a result, from July we will be introducing unannounced inspections."
At present, inspectors visit hospitals with an idea of areas of possible concern but are free to react to what they witness on any given day, changing the focus in response to problems they observe or which are raised by staff, patients or visitors.
If hospitals know inspectors are coming it is said this makes it easier to guarantee a chance to witness an area of work or speak to senior managers. However, while there can be advantages to giving hospitals foreknowledge of inspections, Ms Brimelow said the public were keen on spot-checks and believed they were the best method of ensuring high standards.
"I am publishing reports without fear or favour based on what I see on the day," she said. "We publish what we find and expect action to be taken.
"I have a duty to look at services through the eyes and ears of the public. They look to independent inspection for protection."
HIS does not have the power to impose sanctions or financial penalties on under-performing health boards, but rather aims to work with hospitals to tackle problems. Its method is to demand changes and to help managers to achieve them using a team of health improvement advisers.
HIS chairwoman Denise Coia said the NHS had previously found it difficult to embrace scrutiny, but the agency's approach – promoting improvement rather than lambasting boards for failings – was a sign of a more mature approach. The involvement of members of the public as lay inspectors is also a key part of HIS's approach.
Previous inspections have highlighted the need for improvement at Hairmyres Hospital in East Kilbride, NHS Lothian's Western General and the Western Infirmary in Glasgow.
In April, a report on the Royal Alexandra Hospital in Paisley demanded urgent improvements after HIS determined that some patients had "do not resuscitate" instructions in their notes, with no evidence that this had been discussed with them or their families.
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