NHS Scotland crisis: 'Significant issues' at Scotland sterilisation lab leaves operations at risk of cancellation

“Significant issues” with a sterilisation lab at a major health board has left operations and surgeries at risk of cancellation, a new report has revealed.

According to a report from NHS Lothian, the health board’s hospital sterilisation and decontamination unit (HSDU) is at a “very high risk” of being unable to meet current or future capacity demands for theatre equipment.

The report says this is due to “physical space limitations” and “lack of staff with appropriate competence to maintain and repair key equipment”, leading to the possible “closure of operating theatres and subsequent cancellation of patient operations”.

Operations at NHS Lothian were postponed for a fortnight in August last year due to a leak in the ceiling of the HSDU, prompting the health board to seek assistance from neighbouring local authorities. Now there is a “significant risk” of patient operations being severely impacted should the HSDU be unable to function once more due to the site’s physical limitations and staff shortages.

Scientist working with her microscope

The HSDU is based at the Royal Infirmary of Edinburgh and processes about 400 trays of surgical instruments a day.

Morag Campbell, director of estates and facilities at NHS Lothian, said: "There are significant issues with physical space limitations in the current [HSDU] department and a shortfall in staff to maintain and repair key equipment. A detailed plan is in place, overseen by robust governance processes, to make the necessary upgrades.

"Although we've made important progress in recent months, this remains an ongoing process and we recognise there is much more to do to ensure both the short and long-term functionality of the HSDU."

The actions demanded by NHS Lothian’s plan include replacing certain equipment due to age, reviewing steam generation, water, power supply and ventilation, and reviewing “external, private providers for resilience in the event of an adverse event causing disruption to decontamination”.

Health boards have previously been able to rely on other local authorities when HSDU capacity has dropped, as well as third party organisations. Support from a service in Liverpool was recently needed to maintain part of NHS Scotland's sterilisation service.

However, the NHS Lothian report notes “there is a risk that use of third party, by way of resilience, will come at significant cost to the organisation”.

Furthermore, “there is a risk of a lack of guaranteed external, or neighbouring, [health] board support for longer than short-term duration (days/weeks) in the event of significant failure”, the report said.

NHS Lothian is progressing a business case to the Scottish Government to replace its HSDU unit, but the success of this bid will be dependent on the availability of capital funding.

A spokesperson for NHS Scotland Assure, part of NHS National Services Scotland, said the strategy for decontamination arrangements across the health service was being reviewed at a national level.

"A dedicated decontamination collaborative programme was set up to address capacity challenges, identify opportunities to increase resilience and optimise service,” the spokesperson said.

"Health boards have a contingency and resilience plan. This includes the use of neighbouring NHS facilities as priority and alternative available facilities when necessary."