1 Feb 2017

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

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.”

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

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.”

The hedgerows and boundaries grant, individually worth up to £5,000, is designed to help farmers and other land managers improve important farmland boundaries.

The application window for the £5 million scheme closes on 28 April. Farmers can apply for a one-off grant towards the restoration of a range of traditional boundaries including hedgerows, dry stone walls, stone-faced banks and earth banks. Nearly 800 applicants were successful last year.

Guy Thompson, Chief Operating Officer of Natural England, said:

Hedgerows, dry stone walls and earth banks are a quintessential part of the English countryside. Not only do they perform a vital agricultural role in protecting crops and livestock from the elements, they help support a variety of wildlife. Increasingly farmland boundaries also play a major role in preventing soil loss as well as reducing pollution and flooding. I’m pleased that this grant will help to support these traditional boundaries and the wider benefits that they bring.

Payment rates are fixed for each item. These include hedge-laying or coppicing, hedgerow restoration through gapping-up, stone-faced bank repair and stone wall restoration, which can include a top wiring supplement.

Like the rest of the Countryside Stewardship scheme, the application process is competitive. Applications score more highly if the business has been in a previous Environmental Stewardship agreement or England Woodland Grant Scheme. Priority is given to smaller holdings and restoring hedges or walls is preferred to stone-faced or earth banks. More points are awarded if the application is for more than £1,000, and if the holding is part of a group receiving Facilitation Fund payments.

Grants are not available on land parcels already within Mid or Higher Tier Countryside Stewardship, a live 2016 Hedgerow and Boundary Grant, Higher Level Stewardship or Uplands Entry Level Stewardship on 31 July 2017. Land parcels in Entry Level Stewardship can be included in applications, as long as other eligibility criteria are met.

Grant offers will be made to successful applicants from July 2017. The deadline for submitting claims to Natural England is 31 December 2018.

Customers can apply by downloading an application form or by using the new online application process which is expected to be available on the Rural Payments service from early March 2017.

For enquiries (media only) contact: Mary Tomlinson, Senior Press Officer, Natural England. Email: mary.tomlinson@naturalengland.org.uk Telephone: 07771 834 975.