Inspector calls - are NHS staff too busy for improvement work?

“We’re committed to driving up standards in the care of older people in hospitals, which is exactly why this Government introduced these inspections,” said Health Secretary Shona Robison in response to yesterday’s report from the Royal College of Nursing (RCN) Scotland which suggested fundamental standards of care for older people in Scotland are being compromised by pressures on the health service.

The report looked at 35 inspection reports by Healthcare Improvement Scotland (HIS), and the Cabinet Secretary was quick to defend the process. What is perhaps most worrying about the RCN report, though, is an apparent lack of lessons being learned by overworked departments.

“There does not appear to be learning and improvement across different hospitals in the same NHS Board area. A poor inspection in one hospital may be followed a few months later by a poor inspection in another hospital in that Board where the same issues are revealed. Some NHS boards are evidently struggling to share learning and make the improvements needed,” it reads.

The raison d’etre of HIS is the understanding that improvement and scrutiny need to go hand in hand to drive up the quality of care, and while the RCN document falls short of criticising HIS, it is explicit about the need for long-term strategy from the Government.

“Why, when there is so much attention on the inspections of older people’s care, has HIS’s improvement programme for the care of older people only been guaranteed funding until March 2016? We acknowledge the recent announcement of £2.5m to HIS for a wide range of activities, but this makes no specific reference to improvement work for older people in hospital,” it states.

HIS chief executive Angiolina Foster said they had produced their own overview report last year which “identified a number of areas of good practice including an increased awareness by staff of the issues facing older people in NHS Scotland hospitals and patients being consistently treated with dignity and respect. However, we also identified areas for improvement including the flow of patients in acute hospitals and the practice of boarding (when patients are moved from one ward to another to meet the needs of the service and not because of the patient’s clinical needs)”.

But the question remains: are staff on the ground too busy dealing with bed-blocking and patients waiting to do improvement work?

This was taken from Holyrood's weekly health briefing. You can sign up to receive it free every Friday morning here