Edinburgh hospitals' inquiry: 'Ambiguity' surrounding ventilation standards in Sick Kids hospital contract

Counsel to inquiry lodged 106 page closing submissions document

The specification for the ventilation system that led to the last-minute cancellation of the opening of Edinburgh's new Sick Kids Hospital did not clearly conform to “relevant guidance”, with “ambiguity” in the contract surrounding whether it had to fully comply with agreed standards, the Scottish Hospitals Inquiry has been told.

In their closing submission following two hearings about the Royal Hospital for Children and Young People and Department of Clinical Neurosciences, counsel to the inquiry said the arrangements for the strategic definition, preparation and brief, and concept design contributed to the problems that arose in the hospital’s ventilation system, with a “lack of clarity” in the brief provided to tenderers during the procurement stage.

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They also said there was an error in what was known as the ‘environmental matrix’, which set the air-flow requirements for critical care at four air changes an hour instead of ten. The mistake was attributable to a human transcription error, according to the counsel, and had it not occurred, the problems with the ventilation system were “unlikely to have arisen”.

The hospital, next to the Royal Infirmary at Little France, was due to welcome its first patients in July 2019. But the plans were halted after the ventilation in critical care was found not to comply with national standards. The hospital eventually opened fully in March 2021, at an extra cost of £91.6 million. NHS Lothian was forced to pay £1.4m every month for the empty and unused hospital between February 2019 and February 2021 because it had already officially been handed over by the builders.

The closing submission, written by John MacGregor KC, deputy counsel to the inquiry, and his colleague, advocate Ross McClelland, junior counsel to the inquiry, heard the problems were “exacerbated” by the decision the reference design team, including the engineers that designed the environmental matrix, would be “ring fenced” from the procurement exercise. This means that bidders were unable to discuss issues with the engineers.

The 106-page document also states there was a “lack of direct contact” between clinicians and bidders during the procurement exercise, which was “highly unusual” for such a project. “Had there been more clinical input,” Mr MacGregor and Mr McClelland wrote, “there is a chance that the problems could have been identified and spotted.”

Their submission adds there was “no evidence” indicating any deliberate concealment or failure to disclose wrongdoing. “The evidence indicates that the errors in the environmental matrix arose from human error,” it explains. “This was a genuine mistake that was not spotted in the period prior to financial close.”

The inquiry is looking into ventilation issues at the Royal Hospital for Children & Young People at Little France. Picture: Scott LoudenThe inquiry is looking into ventilation issues at the Royal Hospital for Children & Young People at Little France. Picture: Scott Louden
The inquiry is looking into ventilation issues at the Royal Hospital for Children & Young People at Little France. Picture: Scott Louden

However, the submission also raised questions around the fact there was no independent technical evaluation of the project carried out to “provide comfort” to the Scottish Government, noting: “The chair may wish to consider whether such an assessment would have been appropriate for a project of this nature as the work of the inquiry continues.”

The inquiry, chaired by Lord Brodie, will reconvene on June 12 where it will hear about ventilation, water and drainage issues relating to the Queen Elizabeth University Hospital campus in Glasgow.

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