NHS Lothian was criticised last June in a review that condemned the leadership team at the health authority, highlighting a breakdown in trust between medical and nursing staff in the A&E department, with senior management’s attempts to resolve the issue proving “unsuccessful or detrimental”.
The report, ordered by former health secretary Shona Robison after a whistleblower raised concerns, was carried out by the Academy of Royal Colleges and looked into the emergency departments at St John’s, the Royal Infirmary of Edinburgh and the Western General hospitals.
It said staff at all levels felt there was “limited focus” on emergency care from the board and found evidence of bullying and harassment, lack of leadership and a failure always to prioritise patient safety and quality of care.
The Scottish Government has now commissioned a troubleshooting team chaired by Jim Mackey, chief executive of Northumbria Healthcare NHS Foundation Trust, to support NHS Lothian with the implementation of the recommendations in the report.
The review called on board members to clarify the governance structure and supporting framework, with high-quality, safe care for patients as the key objective. A more transparent culture within NHS Lothian allowing staff to air concerns and the adoption of a team-based approach to the management of the four-hour A&E waiting time standards were also among a number of recommendations made.
A Scottish Government spokesperson said: “Performance at the Royal Infirmary in Edinburgh has been challenged over the last few months, therefore we have commissioned the help of an external team to support the board with the implementation of the recommendations in Professor Bell’s report.
“This approach of learning and mutual aid is commonly used to enable the NHS to improve, and continue to provide high quality care. Drawing on clinical and operational expertise from across NHS Scotland and NHS England, the team offers support to NHS Lothian to implement a programme of continuous improvement. The team is chaired by Jim Mackey, CEO Northumbria Healthcare NHS Foundation Trust who brings a wealth of experience in quality improvement and delivery of safe high quality care.”
Keiza Dugdale, Labour MSP for Edinburgh and the Lothians criticised the decision to draft in an English expert to “fix the mess”.
She added: “The performance of NHS Lothian has been unacceptable for several months, despite the best efforts of dedicated staff who have been put under too much pressure. Sending in a taskforce is welcome and suggests SNP ministers are finally waking up to the fact they have starved NHS Lothian of cash and resources for too long. With winter likely to put hospitals under more pressure, patients and staff in the ERI and across Edinburgh deserve better from this failing government.”