NHS Lothian told to improve cleanliness at hospital

They issued the instruction after inspectors visited the hospital last November, raising "concerns about the cleanliness of the environment and patient equipment" in ward two, where cancer patients are treated, with senior managers.

On the second day of the inspection they highlighted "concerns about the cleanliness of the patient environment and patient equipment on a further two wards", the regional infectious diseases unit and a gastroenterology ward.

The HEI report said there was evidence that the NHS board was not complying with standards to "protect patients, staff and visitors from the risk of acquiring an infection".

It noted the standard of cleanliness of the patient environment was "poor" and stated that the standard of cleanliness of patient equipment was also "poor".

In some wards they found dust on both high and low level areas while there was mould around a shower surround in ward 43 along with mould on shower heads in ward 50.

Of 29 bedframes and handrails that were inspected, 22 were found to be contaminated - with one of these in a room that was being readied to care for a patient with viral haemorrhagic fever in the regional infectious diseases unit.

A total of 16 of the 18 patient armchairs that were looked at were contaminated while 16 out of 21 commodes or toilet seats were contaminated with faeces, blood or body fluids.

Meanwhile, of the 18 mattress covers that were inspected, seven were contaminated, with the inspectors also spotting faecal contamination to patient handrails in toilets and to toilet-roll dispensers in one of the oncology wards.

An HEI team returned to the hospital to carry out an unannounced inspection just over a week later and found "the standard of cleanliness of the patient environment and patient equipment had improved".

But they said there were still a "few minor exceptions to this".

HEI chief inspector Susan Brimelow said: "We carried out an unannounced inspection to the Western General Hospital on Tuesday 18 and Wednesday November 19 2014.

"Due to significant concerns about the cleanliness of patient equipment and the environment, we escalated our findings to senior management in the hospital.

"We requested that NHS Lothian take immediate action to address these issues and produce an improvement action plan.

"We returned unannounced on Thursday November 27 2014 to assess progress against the improvement action plan and found that significant improvements had been made.

"NHS Lothian must address the requirements and make the necessary improvements as a matter of priority."

Melanie Johnson, executive nurse director at NHS Lothian, said staff had acted on the inspectors' findings as "a matter of urgency".

She stated: "We recognise that some standards were below those we would expect and I apologise to any patients who may have been affected. I would also like to reassure them that those areas have been rectified.

"Since the first of the visits in November, immediate changes were put in place to address all areas that were singled out for improvement.

"A detailed action plan was drawn up and all points have been completed. Many of these significant improvements were proven during the subsequent unannounced visit by inspectors as is detailed in the report.

"In February, we will also pilot a new model of working which will see some changes to the existing roles of some nursing and domestic staff. It will place a greater emphasis on cleaning around patients' bed areas.

"We have also asked Health Protection Scotland, an independent body designed to provide advice, support and information to health professionals to help protect health, to support our teams. We have asked if they can identify any other areas that can be strengthened or enhanced."