Review of Edinburgh children’s hospital build finds some records 'could not be found'

Records and documents “for the effective and safe operation” of Edinburgh's Royal Hospital for Children and Young People (RHCYP) “could not be found”, according to a final review into the hospital build.

Further, the second report by National Services Scotland (NSS) found more problems in how the hospital’s fire and electrical systems were built.

The report stated “some of the records and documents necessary for the effective and safe operation of the hospital could not be found”, and recommended NHS Lothian “should require” the hospital builders, Integrated Health Solutions Lothian (IHSL), “to rectify the filing structure of the documentation and verify that the information contained is both complete and accurate”.

“Healthcare organisations have a duty of care to patients, their workforce and the general public to ensure a safe and appropriate environment,” the report said.

“This requirement is identified in a wide range of legislation. At the most senior level within an organisation, the appointed responsible person should have access to a robust structure which delivers governance, assurance and compliance through a formal reporting mechanism.

“The review identified that for both IHSL and NHS Lothian, there appeared to be omissions in the identification, appointment and definition of key roles in an effective management structure. Additionally, some records which are necessary to demonstrate compliance with appropriate specifications and guidance remain outstanding.”

In response to these issues, NHS Lothian said: “Additional information has been requested from IHSL. The building information and operational manual are currently being reviewed and quality assured by IHSL.

“The final suite of documents will be transferred on hard drive from MPX to IHSL/NHSL in Feb 2020 as agreed,” the health board said.

The review also found a lack of smoke dampers, which prevent the spread of smoke to other spaces in the same building, “in areas where rooms are regarded as being used as sleeping accommodation”. These rooms were instead fitted with “fire dampers”.

“The risk consequence of this in the event of a fire could be that smoke would travel through ventilation into adjoining rooms and the corridor which is the escape route before the fire dampers would be actuated,” the review found.

It also found issues around electrical cabling and fire ratings.

“There is also the potential for single points of failure due to the length (and routing) of cables between these distribution boards and the uninterruptable power supply (UPS),” the report said.

“The power supply to medical IT systems should be fire rated / protected and it is not clear if this has been achieved. The medical IT protective conductors are not wired from the respective medical IT cabinet.”

Additionally: “A number of the wall mounted Earth Bonding Bars (EBB) are not installed correctly.

“This was directly observed, additionally, dirt and debris ingress material could be spread when the EBB are opened for the annual testing. This should be considered by the service provider as part of their maintenance plan.”

Health Secretary Jeane Freeman said she had written to staff again on Wednesday, “to keep them informed of the latest developments and to express my continuing gratitude for their dedication and professionalism”.

“Over the past few months they have continued to provide high-quality clinical services and care in what have been very difficult and disappointing circumstances,” she said.

“The safety and well-being of all patients and their families has always been and will remain top priority, and I am truly sorry for any impact the current situation has had on them.”

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NHS Lothian chief executive Tim Davison thanked NSS for its “diligence and commitment in carrying out their assessment so that we can all be assured the building is compliant with national standards and takes account of the very latest thinking on building safety”. 

"We are pleased there are no new substantive compliance issues here that may affect the timeline,” he said.

“The ventilation system in critical care remains the main issue and we continue to work through the remaining remedial works to ensure DCN [Department of Clinical Neurosciences] can move in in the spring. We are also carefully risk assessing possible further enhancements that can be achieved without affecting the current timeline.”

Last month Freeman told the Scottish Parliament the hospital’s opening would be delayed until autumn 2020, and the changes to bring the hospital up to the required standards would cost at least £16m. DCN will be the first to move to the new site, spring 2020.

On Wednesday she said there would not be a change to this timeline.

“This second report from NSS has identified remedial and improvement work required within the fire and electrical systems and that will be factored into a wider plan of work being taken forward to ensure safety at the RHCYP and DCN.

“As I set out in parliament last month, I expect the DCN to move in spring 2020, with the rest of the children’s hospital migrating to the new site in autumn next year."

Freeman has also announced a public inquiry into the hospital build.