NHS Grampian was warned of 'intolerable risk'

Senior NHS Grampian clinicians formally raised concerns with absorption astir an “intolerable” level of hazard 3 months earlier a captious incidental was declared, BBC Scotland News tin reveal.

NHS Grampian declared the captious incidental past week that saw immoderate ambulance patients diverted to hospitals extracurricular its country owed to request astatine Aberdeen Royal Infirmary (ARI). It was aboriginal stood down.

A missive from members of the Medicine and Unscheduled Care (MUSC) enactment squad backmost successful August warned that not capable was being done to conscionable the expected summation successful request implicit winter.

NHS Grampian said the points successful the missive had been considered and "enormous challenges" were being faced by its teams.

NHS Grampian said it had to instrumentality the "significant step" past Thursday aft sustained and continuing demands astatine ARI.

Patients would beryllium diverted to Dundee and Elgin wherever "clinically appropriate", though life-saving attraction was inactive delivered astatine ARI.

After it was stood down, wellness chiefs said the infirmary had entered a “recovery phase" and determination would beryllium a reappraisal of the incident.

The August missive to elder absorption said: "Over the past 12 months aggregate risks person been reported and recorded from each areas of the portfolio, some formally and informally.

"Despite this, we are experiencing a deterioration successful the show against astir measures and targets and the prime of attraction we are capable to present to patients.

"We are progressively acrophobic astir the interaction this sustained unit and hazard is having connected our staff. We spot regular grounds of individuals and teams who are experiencing harm from the required workload and inability to present effectual attraction for patients with the resources available."

It added: "We are alert that these concerns person been escalated antecedently and contempt reassurances, this has not resulted successful immoderate important improvement."

The captious issues raised included unit wellbeing and longer word improvement.

"The existent trajectory of show and occupancy crossed MUSC successful caller months suggests continuous deterioration," the missive said.

"There is nary grounds to enactment immoderate planned betterment enactment oregon capableness changes that volition conscionable the impending summation successful request seen implicit October and sustained implicit [the] wintertime period.

The missive said the authors were alert of the fiscal unit crossed NHS Grampian and the grade of the projected overspend.

NHS Grampian interim main enforcement Adam Coldwells told BBC Scotland News helium and different elder manager had considered the points raised successful the August missive and they had some written to and met the authors.

"Continuous treatment with, and proceeding the challenges of each our colleagues, is an integral portion of some knowing the issues and uncovering the close solution," helium said.

"There are tremendous challenges facing our teams, not lone successful medicine and unscheduled care, but successful different parts of acute care, successful assemblage hospitals, and moving retired successful the assemblage itself. The past week has shown those challenges play retired successful existent time."

Mr Coldwells said determination was nary "single solution" to these problems and added NHS Grampian has the lowest fig of infirmary beds per caput of colonisation successful Scotland.

He added: "We proceed to look astatine ways to amended travel wrong the footprint crossed the full of wellness and societal attraction successful Grampian. In addition, our colleagues successful Scottish authorities person committed to enactment that enactment arsenic necessary.

"The hard enactment and dedication of our teams cannot beryllium understated successful specified hard times."

Speaking connected Monday, First Minister John Swinney said ministers were successful discussions with NHS Grampian astir the incident.

"The authorities volition proceed to enactment with NHS Grampian, listening astatine each times to the objective workforce, to marque definite that we plan services, that we enactment the resources in, and that we instrumentality the close attack to marque definite that we person sustainable wellness services that conscionable the needs of radical successful each parts of the country," helium said.

NHS Grampian said successful the past week mean occupancy astatine ARI was 111%. The infirmary has not been nether 100% occupancy since September. At Dr Gray’s successful Elgin, it has been astatine 124% and has besides not been nether 100% since September.

The captious incidental led to immoderate elective procedures and appointments being postponed, but not for crab attraction and diagnostic tests.

BMA Scotland said it was "extremely concerned" by the timing of incident, up of the engaged wintertime season.