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Tens of thousands of ‘adverse events’ in Scotland’s dementia and geriatric wards

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1 Feb 2017

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Dozens of “adverse events” are recorded every day in the dementia and geriatric wards of Scotland’s hospitals, new figures have shown.

A Freedom of Information request revealed 167,041 such incidents have occurred in the past six years as an under pressure health service attempts to deal with an ageing population.

The Scottish Conservatives said the data illustrates problems many vulnerable patients have encountered, as well as the daily challenges facing staff in elderly inpatient wards.

Incidents range from falls and assaults on staff to self-harm and patients absconding from secure facilities.

In NHS Borders, one staff member was injured while receiving training in dealing with aggressive patients, and in Fife there were reports of bomb threats and suspicious packages, as well as “rooftop protests”.

Much more seriously, bosses at NHS Greater Glasgow and Clyde said adverse events had resulted in the deaths of 49 patients since 2011.

In some cases, staff shortages were posing such a risk that employees formally logged that as an adverse event in itself, while in the Western Isles a lack of staff was blamed directly for allowing a patient to climb out a window and escape from hospital.

Shadow health secretary Donald Cameron warned these problems would become more commonplace as Scotland’s population aged, and cases of dementia increased.

The true figure is likely to be even higher, as some health boards were unable to provide the information, or supplied only the most serious of events.

Last year, it was revealed that maternity units across Scotland had also endured thousands of adverse events, prompting calls for an investigation.

Scottish Conservative shadow health secretary Donald Cameron said:

“Patients in dementia and geriatric wards are among the most vulnerable in our hospitals, and deserve the best possible care.

“And there’s no question that wards dealing with dementia patients are incredibly challenging places to work: many of these incidents illustrate that.

“In such environments many of these adverse incidents will have been unavoidable, and it’s a credit to hardworking NHS staff that they deal with these day, in day out.

“But patients in these wards, and their families, will be extremely worried at the sheer scale of these flashpoints.

“There are a significant number of incidents which were put down to staffing shortages, or a lack of adequate resources and training, and that very much falls at the Scottish Government’s door.

“As our population ages and conditions like dementia become more prevalent, it’s clear something needs to be done to ensure these incidents don’t increase.

“We need to see a proper plan to make sure our staff and hospitals are equipped for all the future challenges they face.”


Below is a list of the adverse events recorded by health boards for the past six years:

Ayrshire and Arran – 15,043
Borders – 10,252
Dumfries and Galloway – 6399
Fife – 19,308
Forth Valley – 13,629
Greater Glasgow and Clyde – 270
Grampian – 16,426
Highland – 7073
Lanarkshire – 33,092
Lothian – 44,890
Orkney – n/a
Shetland – n/a
Tayside – no response
Western Isles – 659

Total – 167,041

Below is a list of the national figures broken down by year:

2011 – 28,239
2012 – 28,659
2013 – 28,317
2014 – 29,847
2015 – 28,906
2016 – 23,118*

Total – 167,041

*Some health boards only supplied information for part of 2016, which may explain the lower number.

All details were obtained by the Scottish Conservatives through Freedom of Information. For a copy of individual responses, contact the Scottish Conservative press office.

Last year, it was revealed that thousands of adverse events had occurred in maternity units across the country:
http://www.bbc.co.uk/news/uk-scotland-scotland-politics-38055060

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“Reform is an essential part of the future” says Vaughan Gething

Speaking ahead of the conference, Vaughan Gething said:

“2016 was a tumultuous year for our country. A year of unprecedented political upheaval and uncertainty that will impact on society and public service delivery for many years to come.

“But despite that uncertainty and despite record demand, our NHS delivered better health care for people across Wales. Welsh Ambulance performance is now the best in the UK, cancer survival rates continue to improve faster in Wales than any other part of the UK and overall waiting times are down 20% on last year. 

“Whatever services people use – hospitals, GPs, social care, mental health services – they expect good quality care in a timely manner. Above all else, delivering on that is our prime concern.

“Our staff have worked extremely hard this winter and we have seen diagnostic and planned care waiting times reduce dramatically over the past year.  I want to thank them for their dedication and commitment to the values of the NHS and to providing high-quality care.  

“I’m proud of our achievements, but I want us to be more ambitious for 2017. I want us to continue to reduce planned care and diagnostic waits. I want us to build a health service that meets and delivers on the needs of our patients and that is sustainable, in spite of the challenges.

“Reform is an essential part of the future.  If we do not reform then we will not deliver the change and improvement that is needed.  

“This is our mission. It won’t be easy but it will be worth it. 

“It’s time good performance was recognised. I want to encourage the boards and trusts that are operating well, that are delivering for local people, and incentivise excellence in our health service. We will be exploring how we can best make that happen.”

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Press release: Charity payment after water company permit breach

The Environment Agency has accepted an Enforcement Undertaking which will see Northumbrian Water pay £375,000 to charities in the North East after it breached environmental permitting regulations.

The offer also includes actions for Northumbrian Water to improve its operations and infrastructure.

It follows a sewage pollution incident involving West Wylam pumping station, investigated by the Environment Agency on 18 February 2015.

A blockage upstream of the pumping station resulted in raw sewage overflowing into Park Burn, a tributary of the River Tyne, breaching its permit.

Investigations showed significant water quality impact at Park Burn, with sewage odour and litter visible, and ammonia and suspended solid levels above accepted levels. Surveys indicated there had been no significant impact on the invertebrate population in the burn, and there was no impact on the Tyne, due to the river size and flow of the river.

Northumbrian Water carried out an immediate clean-up of the polluted area after it was reported to them.

Wide range of measures

The Environment Agency is making better use of the wide range of measures that are available to bring sites back into compliance as quickly as possible. Along with prosecutions, it uses enforcement notices, stop notices and civil sanctions to either improve performance or stop sites from operating.

The Environment Agency’s use of civil sanctions is in line with recent legislation extending their availability for more offences.

Civil sanctions such as these can be a proportionate and cost-effective way for businesses to make amends for less serious environmental offences. The company must offer to restore or remediate the harm caused by the incident, and demonstrate they will change their behaviour and ensure future compliance with legislation.

Proportionate response

Fiona Morris, Environment Manager with the Environment Agency in the North East, said:

We will always take forward prosecutions in the most serious cases and while we did initially consider prosecution, the company submitted an EU which we subsequently accepted.

We felt it to be a more proportionate response that would benefit the environment – achieving more than if the company had been convicted and fined.

We work hard to protect people and the environment, and a clear regulatory framework with agreed standards and targets has helped to drive major environmental improvements over the last few decades.

We’re continuing to improve our approach to ensure that we remain a fair and proportionate regulator.

The actions offered in the accepted EU, require Northumbrian Water to:

  • Make donations to Tyne Rivers Trust (£134,500), Northumberland Rivers Trust (£59,500), Wear Rivers Trust (£48,500), Tees Rivers Trust (£58,500).
  • Make a donation of £74,000 to Groundwork towards the Land of Oak and Iron Project.
  • Make improvements to site operations and infrastructure, including updated sewerage records, an updated process for asset planning and management and refurbishment of West Wylam pumping station, as well as an accelerated programme of planned upgrades to sewer infrastructure in the area.
  • Further inspections and surveys of the impacted area.
  • Pay Environment Agency costs.

Failure to comply with an EU may result in the offender being prosecuted for the original offence.

See the full list of the most recent enforcement undertakings

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John McDonnell MP responds to Resolution Foundation Report

John McDonnell MP, Labour’s Shadow Chancellor, commenting in the Resolution Foundation report out today, which shows that Britain is on course for the biggest increase in inequality since Thatcher, said:

 “This report is damning of the unfair economic policies of this Chancellor, as the gap between working families and a wealthy few gets wider, with the poor getting poorer and the rich getting richer. It demonstrates to us all once again that the economy under a Tory government will be rigged for those at the top, with poor and middle income households facing their worst Parliament for income growth since the 1960s.

“Labour called on the Government at the Autumn Statement to end the unfair cuts to in work benefits, whilst they were going ahead with tax giveaways to a wealthy minority, but Philip Hammond chose to carry on with the work of his predecessor.

“It is becoming clearer by the day that working families will be forced to pay for a Tory Brexit that favours the rich and not the rest of us, as our country faces its biggest rise in inequality since Margaret Thatcher.

“The next Labour government would rewrite the rules of our economy in favour of working families, with a real living wage expected to be £10 an hour by 2020, and proper investment to ensure no one and no community is left behind.”

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Press release: Lack of controls over cash collections

The Charity Commission (‘the Commission’) investigated Al-Hassan Education Centre (1078159), a mosque and education centre based in Leeds after it repeatedly failed to file its accounts – see endnote 1. The Commission concluded that the trustees mismanaged the charity.

The Commission uncovered inadequate financial governance at the charity and that the trustees were not able to fully account for the charity’s funds in relation to cash collections and charitable expenditure. The charity also failed to submit accounting information for the financial years ending 31 March 2012 and 31 March 2013.

The inquiry also found that there were wider governance failures within the charity whereby the trustees were not adhering to some of the provisions within their governing document including: failure to hold Annual General Meetings since July 2013 or the required 2 trustee meetings a year and that they had no policies for loans and money laundering. The regulator also concluded there had been mismanagement by the trustees due to a lack of financial controls in relation to cash collected and spent following Friday prayers, and a lack of up to date policies and procedures.

The inquiry considered that the trustees had not acted in the best interests of the charity, put the charity’s funds at risk and concluded there was mismanagement and misconduct by the trustees.

On 16 November 2016 the Commission issued an order under the Charities Act to direct the trustees to take certain actions to regularise the charity’s governance, submit its outstanding accounting information and review its policies. The trustees have already taken steps to complete the actions, and the Commission will continue to monitor the charity to ensure that its order is complied with.

Carl Mehta, Head of Investigations, Enforcement at the Charity Commission, said:

The trustees in this case failed to take basic steps to ensure that the charity’s funds were able to be accounted for. This is simply not acceptable and I expect the trustees to take measures to speedily correct this.

For many faith groups, collecting funds in cash is likely to be a regular occurrence as part of worship or devotion. Charities must ensure that they have in place effective and proper financial controls to ensure those funds are safeguarded.

Trustees can use the Commission’s guidance to implement robust internal financial controls that are appropriate to their charity. Internal financial controls for charities (CC8) is available on GOV.UK. There is also a self-check-list for trustees available.

The full report is available on GOV.UK.

Ends

PR08/17


  1. The Charity Commission is the independent regulator of charities in England and Wales. To find out more about our work, see our annual report.
  2. Search for charities on our online register

  3. Details of how the Commission reports on its regulatory work can be found on GOV.UK.

Endnotes

  1. The inquiry was opened on the 25 February 2015. The charity was previously part of the class inquiry in April 2014 for failing to submitting accounting information for the financial years ending 31 March 2012 and 31 March 2013.
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