INSIDE RAIGMORE: Patients speak out on Inverness hospital under pressure
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Cancelled operations, lack of beds, reliance on agency staff, waiting lists for important scans growing, and increased stress on maternity services: Raigmore has a serious set of problems.
Following news last week that the hospital had cancelled planned operations due to “a higher number of trauma cases coming into the hospital putting further strain on an already pressurised system,” politicians across the region raised concerns.
Despite an update stating that pressures have eased somewhat, a spokesperson confirmed that “sustained challenges” remain.
Patients
The Inverness Courier has spoken to patients who feel a lack of resources is dangerously affecting care.
One patient, who wishes to remain anonymous, was told by nursing staff she would be moving wards. While being wheeled past the nurses station, a disagreement started about where she was being taken.
“The nurses had a conversation over my head, with one saying ‘no we can’t take her we have no staff, we only have two nurses on the ward’ and the other saying ‘we’ve been told you have to take her’,” she said. “This went on for 10 minutes.
“Eventually I was put into a day room which had no toilet facilities and curtains didn’t go around the beds. I had injections in my bottom while I was there and as the blind didn’t close properly anyone walking past could have seen.
“At 5.30pm one night a rush of people came in as they realised no doctors had come to see us [myself and an elderly lady also placed in the same room],” the patient said. “We were told it was because no doctors had been informed we were there. They apologised and cited lack of communication.”
The same patient, who is keen to highlight that until quite recently she had always experienced excellent care, also had a difficult experience on another admission to a different ward at Raigmore, which she found to be largely manned with agency staff.
“The standard of care was much less than it had ever been before,” she said. “It was lucky that I knew about my own medical needs as I felt they hadn’t looked at my notes – I felt that at times I was directing them.”
Another person who wishes to remain anonymous told us about their experience with the care of an elderly relative at Raigmore recently, who they found was often being cared for by agency staff who did not seem to have full knowledge of their relative’s reason for admission. “She was left in the same dirty clothes on more than one occasion,” they said. “Our family started a rotation system to try and ensure someone was with her for meals, washing and getting ready for bed. It wasn’t the staff’s fault, but they were too busy to do it all.”
Both of these sources want us to make clear that no blame is being placed on medical staff, who are often going above and beyond for patients under stressful conditions.
Inverness SNP MSP Fergus Ewing commented that staff shortages and bed capacity are the two main problems for the NHS in the Highland capital and many other parts of the country: “There are a very serious set of challenges with NHS Highland. I will be raising concerns with the new health secretary.”
Mr Ewing said that although every instance where patient care is not adequate should be taken seriously, “I have a duty to paint a balanced picture”. He added: “I am often contacted by constituents after operations and treatment who are very happy with the standard of care at Raigmore.”
Maternity
NHS Highland claims plans for a major investment of nearly £9 million for Raigmore’s maternity unit will lead to a transformational expansion in maternity and neonatal care services, and enable more women from Moray and Caithness to give birth in Inverness.
In October 2022 maternity staff wrote a letter to then health secretary Humza Yousaf stating the proposed model of care is “fundamentally flawed” and raised concerns about patient safety. The staff also called plans a “clinically disruptive refurbishment of the maternity unit.”
When going to press the full proposal was not yet finalised, but in its current form would include the addition of one neonatal cot and two “birth areas”.
One new mother, Ashleigh Sutherland, who gave birth at Raigmore recently, believes her experience highlights the problems they are facing.
“When in active labour I should have been taken to the labour suite where I would have had my birthing partner with me and one-to-one care and monitoring from a midwife, both for my baby and myself,” she explained.
“Unfortunately, due to how busy it was, I was left on ward 10 for far longer than I should have been. I was not allowed my partner with me because it was outwith visiting hours. I laboured alone and ended up pushing on the ward.”
She continued: “Only then was I rushed up to the labour suite where my partner was called and just made the birth in time. I went on to have a traumatic birth which could have been very different had the basic care and support been available during my labour.”
Miss Sutherland added that she felt it was horribly unfortunate for staff that they are under such pressure that they are sometimes unable to provide necessary care.
Regional Tory MSP Edward Mountain has been outspoken about the need for a new hospital in Inverness, and claims that the ambitious maternity upgrade will have a knock-on effect to other areas of the hospital which are already under strain.
“While [the upgrade] happens, there will have to be a relocation of the facilities in the maternity ward,” Mr Mountain said. “They are going to have to go into other wards, which means the use of those wards will need to be restricted.”
Above capacity
Mr Mountain highlighted that the hospital, in general, is “bursting at the seams”.
“We’ve reduced capacity in the wards, reduced the number of beds, and we don’t have enough staff, which means it’s going to get worse,” he said. “What we’ve done for the last 10 years is centralise services into Raigmore, which means there aren’t enough facilities.”
Mr Mountain discussed figures obtained via a Freedom of Information request on the number of people on waiting lists for MRIs and CT scans, which he states have all risen considerably between 2022 and 2023. In addition to this, he has found “in 2022/23, the radiology unit has spent nearly £950,000 on locums.”
People who work at Raigmore have spoken to us about issues including a reliance on agency staff and difficulty moving many patients out of hospital due to lack of care resources in the community. None of them felt comfortable enough to be quoted directly.
Mr Mountain echoes the views of all the patients and staff The Inverness Courier interviewed regarding problems at Raigmore Hospital – it’s not the fault of the people who work there: “I have huge respect for our doctors and nurses – we put them in impossible situations.
“I have spoken to doctors and nurses who are frustrated that they are unable to do everything they would want to do for the care of the patients.”
The future
One recent improvement that NHS Highland hopes will see some pressure on Raigmore Hospital relieved is the new £48 million National Treatment Centre (NTC) in Inverness. Hosting NHS Highland’s entire eye care service, including surgical and outpatient facilities, it also delivers a range of elective orthopaedic care, offering hip and knee replacements, foot, ankle and hand surgery.
It has been built as part of a Scotland-wide NTC programme aimed at cutting waiting times for patients.
However it remains unclear how much this will contribute to reducing pressures at Raigmore. “They can only take the operations where patients can get out quickly,” Mr Mountain said.
“If they can’t they will still need to go to Raigmore, which is where the majority of our patients are. It’s all building up to a bigger problem.”
Instead, he thinks we should be focusing on a new well-resourced teaching hospital that’s fit for purpose, in order to attract staff.
Mr Ewing is keen to focus on more immediate improvements. “In the Highlands we have a relatively small number of people to serve,” he said.
“It would be desirable to have a new hospital in the future, but it’s not going to do anything to solve the short-term problems.
“I think some will say work being done at the moment, for example the new orthopaedic centre, are the right steps. Other things are outwith the NHS control locally and have caused staffing problems, such as Brexit. I would like to see more training carried out in Inverness.”
Whatever the next steps are, the patients and staff we spoke to can all agree on one thing: major improvements are needed. The safety of vulnerable people is at stake.
Response from Raigmore Hospital
“While we can’t comment on individual cases due to patient confidentiality, we are very sorry for any distress or inconvenience caused by our current high levels of demand for emergency and unscheduled care in Raigmore. “No matter how busy we are, we want to ensure that all those who attend our hospitals receive high-quality care, and we want to learn from any experiences that fall short of this.
“We encourage patients to share their stories via Care opinion (www.careopinion.org.uk) or by emailing our Feedback Team (nhshighland.feedback@nhs.scot) so that we can record, learn from and improve any issues raised.
“Staff shortages are one of the challenges faced across the NHS and we are working hard to fill permanent positions as well as ensure we have temporary and agency resource available to cover gaps. We have an ongoing recruitment campaign which has successfully filled a number of hard-to-recruit posts, and where possible we use our own permanent or temporary colleagues as they will be more familiar with our settings and processes than agency or locum staff.
“It’s important to note that whatever basis of employment, all of our colleagues have the required skills, experience, qualifications and training for the role they are filling. We are also continuing with some overseas recruitment and have a number of colleagues already with us or in the onboarding process.
“Staffing of inpatient services is not the only challenge we face, with lack of staff for onward care and support to allow prompt discharge of patients, as well as physical capacity in our hospitals and the funding available all contributing to pressure.
“Within radiology, we have recently recruited the equivalent of two full-time consultant radiologists. We will continue to explore ways to make these posts attractive and also review the skills mix to reduce waiting lists.
“The Covid pandemic meant some regular procedures had to be paused and, in common with other boards, NHS Highland is working hard to try and reduce the backlog. We prioritise patients whose cases are the most urgent, which can mean that less urgent cases wait for longer than we would like.
“The longest waits in CT are for cardiac CT and we have recently secured additional activity at the Golden Jubilee [National Hospital in Clydebank] for those patients. Otherwise all patients in CT with a wait of over six weeks have either been scanned or have an appointment booked.
“Within MRI we are working to reduce our overall waiting list, though this will continue to be challenging as we have finite capacity. There is increased demand for unplanned CT and MRI scans, so we need to balance this against routine activity.
“The National Treatment Centre will treat orthopedic and ophthalmology patients. Many of these will be day cases or be able to go home within 24 hours. Others may need to stay longer. Orthopedic patients are assessed based on a number of factors and more complex cases will be treated at Raigmore. People treated at the NTC will, of course, no longer be on the Raigmore waiting list.
“The planned upgrade to maternity facilities at Raigmore will take place over several phases to reduce the impact on capacity.
“The NHS Highland maternity and neonatal business case is due to be considered by the programme board this week, after which it will be submitted to the Scottish Government. As such, it is not yet finalised. Current plans include the addition of one neonatal unit cot at Raigmore and two birth areas within an Alongside Midwifery Unit or Community Midwifery Unit. The latter will reduce demand for acute beds in Raigmore.
“The existing provision in Raigmore will benefit from one additional delivery room and will also be upgraded to meet Best Start standards, including larger ensuite rooms, and reconfigured to allow, for the first time, beds for transitional care. This is important because we have heard from patients that they want this level of care when in labour. The new layout will also include multipurpose rooms which can be used for delivery if needed.”
Feel free to share your experiences with us – whether as a patient or staff – by emailing newsdesk@hnmedia.co.uk
