The Scottish government has published details of an investigation into the issues at the Royal Hospital for Children & Young People (RHCYP). The first patients had been due there on 9th July but the move was halted just a few days before the opening because of issues with the ventilation system.
The opening was put back indefinitely. Health secretary Jeane Freeman now expects the Department of Clinical Neurosciences (DCN) to move in spring 2020, with the rest of the Children’s Hospital migrating to the new site in autumn next year.
The problems have led the Scottish government to announce plans to create a new national body that will have oversight for the design, planning, construction and maintenance of major NHS Scotland infrastructure developments.
Two reports into the problems at RHCYP were commissioned by the health secretary in July. An independent review of the governance arrangements for RHCYP by KPMG has found that the main issue with ventilation in critical care stemmed from an error in a document produced by NHS Lothian at the tender stage in 2012. This was despite the requirement that the project should also adhere to relevant technical guidance.
The KPMG report attributes this to human error and confusion over interpretation of standards and guidance. It also concludes that opportunities to spot and rectify that error were missed.
Freeman said: “I am of course bitterly disappointed that a mistake made in 2012 was not picked up earlier. This is a publicly funded project of strategic importance, which has not been delivered by NHS Lothian in compliance with the standards and guidance. The delay we now face will be borne by NHS Lothian staff, by patients and their families and the additional cost will be to the public purse.”
Freeman had also asked NHS National Services Scotland (NSS) to undertake a detailed assessment of compliance of all building systems that could impact on patients and staff at the new site. This has identified a range of issues which need to be resolved prior to occupation of the building, including ventilation and water systems. The NSS report makes a number of recommendations which NHS Lothian have accepted and the Scottish government will publish an action plan from the board along with both reports.
The contract was awarded in 2015 to the Integrated Health Solutions Lothian consortium, which is led by Macquarie Capital, with Brookfield Multiplex as design and build contractor and Bouygues E&S as facilities management provider.
The scale of the challenge relating to the delivery of the new hospital means that NHS Lothian has been escalated to ‘level 4’ in the NHS Board Performance Framework for this specific issue. The Scottish government will put in place a senior programme director who will take responsibility for day to day delivery of the RHCYP from now until the site is fully occupied.
In addition to the ventilation issue previously identified in the critical care area of the hospital, remedial action is required on the quality of work in a number of areas, with specific issues identified in haematology/oncology. Independent testing identified no widespread contamination of the water systems, but NSS has recommended some remedial and precautionary actions, as well as system-wide disinfection prior to occupation. NSS also recommend active monitoring for drainage and plumbing, however both these areas are considered low risk.