Scottish patients ‘at risk with single room plan’
VULNERABLE patients will be left isolated and lonely, with a greater risk of suffering accidents and falls, under a policy to build all new hospitals with single rooms only, senior doctors have warned.
The Scottish Government is pressing ahead with plans to axe traditional multi-bedded wards on new NHS sites, with almost a third of hospital beds already in single rooms.
There is growing concern that the 100 per cent single rooms approach will leave some patients isolated, hindering their recovery, as well as adding millions to the building and running costs of hospitals.
Dr John Womersley, a retired public health consultant who worked for the NHS in Glasgow for almost 30 years, has now gathered together the views of other doctors and patients groups and written to chief medical officer Harry Burns outlining their fears.
He wrote: “My concerns are that the policy deprives the considerable number of patients who prefer (or would benefit from) company of that choice, and that the evidence base for the policy is dubious.”
Several major NHS building projects are currently underway which will follow the single rooms approach.
These include the £200 million replacement hospital in Dumfries and the £842m “super hospital” in south Glasgow.
Hospital volunteers and doctors contacted by Womersley spoke of patients being “frightened, even terrified” of being in a single room on their own, he said.
One volunteer in Dumfries said she had met an elderly patient in a double room with only a single bed who was “absolutely terrified”. The volunteer said: “She hung on to my hand and pleaded with me not to leave her.”
A rehabilitation specialist in Dumfries has also highlighted her concerns to bosses about the negative consequences of only having single rooms in her department, where patients often stay for long periods.
She wrote: “A few days in a single room might be tolerated but three months would be unpleasant. When patients have needed periods in a single room on the unit they often describe this time as ‘solitary confinement’ because of the lack of social interaction.”
The doctor said other medical and nursing staff agreed that they wanted to keep some multi-bedded rooms for the sake of their patients.
“100 per cent single rooms will make them isolated and poorly motivated and will hinder their progress to independence increasing the number of bed days in hospital,” she said.
Womersley said he had heard from patients groups who said many people would feel “unhappy, lonely and distressed” if left in single rooms.
“In shared rooms you can find friendship and look out for each other. If someone’s drip is coming out, or someone doesn’t look as well as they should then they can draw attention to it,” he said.
Former health secretary Nicola Sturgeon announced the single rooms policy in 2008, with promises that this approach would help prevent the spread of infections and improve patient dignity.
Her successor Alex Neil last month revealed that already 26 of the country’s 218 hospitals had 100 per cent single rooms, saying there was “strong evidence” of their effectiveness.
But Womersley said his discussions with NHS board members, doctors and patient representatives suggested many believed there was no evidence for the benefits highlighted by politicians.
Womersley said: “Nobody is saying everyone should be in the large wards we used to have or even in four-bedded bays.
“But what sensible people are saying is that we should have a reasonable mix of accommodation so people who want or need single rooms for a particular reason have them, but those who prefer company when they are in hospital for a bit longer should also have that choice.”
Dumfries consultant Dr Chris Isles said he was “baffled” by the determination to press ahead with 100 per cent single rooms when surveys had suggested patients wanted a mix of provision.
He said: “I am all in favour of a substantial increase in the proportion of single rooms when a new hospital is built – Dumfries has 21 per cent at present and could do with at least 50 per cent. But to dictate that this must be 100 per cent, when surveys suggest that a significant number of patients crave the company of shared accommodation, flies in the face of all reason.”
In other evidence submitted to the CMO by Womersley, one senior NHS official in Dumfries and Galloway highlighted concerns over added costs.
He said: “Having 100 per cent single rooms adds some 15 per cent to the £200m cost of a 50/50 mix of single rooms and four-bedded wards.”
Jason Leitch, Scottish Government clinical director, said: “There is evidence of the effectiveness of single rooms in minimising risks of healthcare associated infections and in protecting dignity for patients, and that is why in Scotland we are moving to greatly increase the number of single rooms.”
He added: “Single rooms provide a better and safer environment for patients and will enhance their experience during their stay in hospital.”
PROS AND CONS: BEST PRACTICE
For single rooms
• Help reduce the spread of hospital-acquired infections, such as C difficile and MRSA.
• Reduction in mistakes such as medication errors as patients are clearly separated.
• Communal social areas mean patients can socialise while also having the benefits of single rooms.
• Greater privacy for patients and their visitors.
• Protecting patients’ dignity during treatment and recovery.
Against single rooms
• Vulnerable patients feel lonely and isolated without company.
• Patients with mobility issues unable to access communal spaces.
• Increased costs of building, staffing and cleaning single rooms.
• Other patients not around to alert staff if someone falls over or becomes ill.
• Patients scared they will be forgotten about or die alone.
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