The Health Environment Inspectorate is responsible for reducing risk to patients through a regime of inspecting hospitals for any infection risk. They focus on ensuring that the care facility is safe and clean and then they publish the results of their inspections.

Most recently they have inspected St John’s Hospital in Livingston without notice in August. They first visited on 20 and 21 August but due to concerns over the cleanliness of the A & E department they returned the following week.

The team found six trolley beds in the A & E department all of which were contaminated, some with body fluids, and mattresses were found to be stained. But in the resuscitation room there was blood on the lamps, on the walls, under worktop surfaces and on the sharps bin. This matter was raised immediately with the most senior nursing staff and the senior management at NHS Lothian. By the time of their second visit the inspectors were more satisfied with the level of cleaning, although there was still dust on high shelves and on patient equipment trolleys in the X-ray room.

They have concluded that the hospital needs to address matters relating to cleanliness, the way that staff are dressed and ensuring that their staff know how to clean up blood using chlorine and detergent.

The report mentions that one member of staff had long untied hair, another was wearing a ring with a stone, one had long painted finger nails and a fourth was wearing inappropriate shoes.

During their visit the inspection team interviewed only nine patients but also handed out 71 questionnaires to patients.  A previous visit to the hospital in January 2012 also required action in four areas and two recommendations to the Health Board.

Speaking of the report, Susan Brimelow, HEI Chief Inspector, said “Overall, our inspection found evidence that St John’s Hospital is complying with the majority of infection prevention and control standards to protect patients, staff and visitors from acquiring an infection.

“The hospital environment was clean, and we observed good staff compliance with sharps management and hand hygiene practices. However, we did identify areas where improvements are needed.

“We noted mixed compliance with national dress code policy among staff and found a poor standard of cleanliness in the accident and emergency department. As a result, we escalated our concerns to senior management and requested that immediate action be taken.

“We re-visited the accident and emergency department on 27 August and found the standard of patient equipment cleanliness had significant improved. This inspection resulted in four requirements and three recommendations which NHS Lothian must address as a matter of priority. We will follow-up on these concerns at future inspections.”

The HEI will follow up on progress being made in light of their recommendations with four months from the date of the initial inspection.

The full report is here.