"I feel our hospital is over capacity"

About: Victoria Hospital (Kirkcaldy)

(as a staff member),

Since December 2012 I feel there have been too many patients for our bed capacity, resulting in patients being placed in inappropriate wards/departments due to lack of beds and delayed discharges.

In some cases elderly dementia patients have been moved up to 7 times in 3 - 4 days, when it clearly states in their notes that due to their delicate condition under no circumstances were they to be moved.

Four bedded wards have had another 2 beds placed in the middle of the room, with no curtains round beds, no buzzers, no piped oxygen etc.

Patients have been put into treatment rooms, storage areas and areas meant only for day cases (no shower facilities, no catering, kitchen facilities etc), men and women mixed in wards.

The management have been saying its a winter crisis, but this is now nearly June and it is still happening and no one seems to have any solutions. Meanwhile the patients are suffering, and we are not giving them compassionate and safe care. Our concerns are falling on deaf ears. How can we be expected to deliver care if our hands are tied?

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Response from Louise Ewing, Patient Relations Manager, NHS Fife

picture of Louise Ewing

Dear old school

Thank you for taking the time to share your concerns with us.

NHS Fife like other Health Boards across Scotland has experienced an increase in the number of patients requiring emergency care over the winter months. There have also been difficulties in moving some patients out of the acute hospital into more appropriate care settings in the community. We have undertaken an audit which demonstrated that about approximately 25% of the people being cared for in the Acute Hospital were not in the appropriate care setting I.e. they did not require acute hospital care.

During the peaks of high demand for patients requiring admission we opened a number of additional beds to accommodate these patients. So, rather than this being an issue of not enough beds, it is more to do with patients being looked after in appropriate care settings.

The situation above required us to ensure that the most sick patients were cared for in the right type of ward. This meant that the patients who were more able were moved to other ward areas so that the sickest patients received their care in an appropriate place.

We would prefer not to move patients to other wards and acknowledge this is not ideal; we only do this when there are no other options available to us.

Currently within NHS Fife we are reviewing how we use the space and beds we have. It is imperative that we get this right so that patients who require emergency care receive it in the Acute hospital and those patients who do not require acute hospital care are discharged to appropriate care settings for their ongoing care. This could be, for example, in a community hospital or in their own home with their relatives and loved ones or with hospital at home support by nurses and other healthcare professionals.

We welcome feedback and would encourage patients and staff to raise concerns locally, to provide us with the best opportunity to resolve any issues as they happen. There are also mechanisms in place for patients and staff to escalate their concerns where there is a need. We recognise that this has been a challenging time and remain committed to further improving the situation.

Caroline Inwood

Director of Nursing

Operational Division - NHS Fife

Victoria Hospital

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Update posted by old school (a staff member)

many thanks for your response but I have to say that nothing has changed we are still working well over capacity .......inappropriate patients being moved to inappropriate depts. and wards .....staff being expected to work in very stressful situations. Managers literally telling staff to put up and shut up .....I am encouraging patients to complain and also contact the media.....enough is enough .....

Response from NHS Fife We have made a change

Thank you for your further response which has been brought to my attention as Chief Executive. I felt it was important that I take the opportunity to respond directly. It is clear that you feel frustrated in this situation and I am disappointed that our internal systems have not enabled us to resolve these issues.

I do want to reassure you about a range of work that is underway to address the issues you describe. We have now agreed to open additional beds on the Victoria Hospital site on permanent basis, have commissioned additional beds in community hospitals to support discharge from acute care and are working on increasing capacity for reablement.

We recognise that these situations will only be resolved if we work together and have confidence to address them, and on that basis I would also like to offer you the opportunity to meet with either myself, George Cunningham, Director of Acute Services, Gordon Birnie, Medical Director or Caroline Inwood, Director of Nursing, in confidence. Alternatively you might like to meet with any other member of the Strategic Management Team to discuss these issues.

I understand that you have already been signposted to our Whistleblowing Policy and have also been given the details of the recently set up confidential National Helpline for NHS employees 0800 008 6112. These provide an alternative route to raise your concerns if you wish to do so.

I also wanted to let you know that I intend to reintroduce the staff briefing sessions which will provide a forum for us to share information with all staff about the work that is underway to address these concerns. It will also provide an opportunity for us to gather feedback from staff. I would like to encourage you and your colleagues to attend these sessions to enable us to resolve these issues collectively.

We are committed to improving both patient and staff experience and again recognise the need for us to do that collectively. I appreciate your feedback and would value the opportunity to discuss further. Caroline Inwood should be your point of contact should you wish to make arrangements to meet.

Thanks again,

John Wilson


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