NHS Grampian carried out elective paediatric dental and ENT surgery for nearly a month after a temporary suspension on all elective paediatric surgery was put in place, according to inspection reports published by Healthcare Improvement Scotland (HIS).
HIS raised significant concerns in July about the delivery of safe and effective care for critically unwell paediatric patients. The suspension was introduced on July 9. However, HIS was later informed by NHS Grampian that the specified procedures continued until August 6.
Eddie Docherty, director of Quality Assurance and Regulation at HIS, said the situation "affected our confidence in the reliability and consistency of the information received from NHS Grampian."
The reports were part of three Safe Delivery of Care inspections carried out during the week of April 27, covering acute care, mental health, and maternity services at Dr Gray's and Aberdeen Maternity Hospital. A separate independent diagnostic review published alongside the reports found "serious patient safety issues."
The inspections identified a range of other concerns. These included a reliance on a locum consultant in the high dependency unit, a lack of assurance around medical cover across 24 hours, challenges for maternity staff accessing consultant input out of hours, and reports that midwives' clinical judgement was sometimes questioned by receiving units. Variable compliance with mandatory training and staff appraisals was also noted.
Inspectors noted positive staff-patient interactions and multidisciplinary care and bereavement support in maternity services. NHS Grampian chief executive Laura Skaife-Knight, who commissioned the diagnostic review, admitted failures recognised in the report. The health board was contacted for comment on the inspection reports.
Analysis
Why This Matters
- The reports expose systemic failures in patient safety and governance within a major Scottish health board.
- The continued surgery after a suspension raises serious questions about internal oversight and communication with regulators.
- Targets set for training compliance and the health board's corrective actions will determine the impact on future patient care.
Background
NHS Grampian is the health board responsible for providing healthcare across northeast Scotland. Healthcare Improvement Scotland (HIS) is the national body that inspects and regulates health services. The reports follow previous warnings from HIS and an independent diagnostic review commissioned by the health board's chief executive.
Key Perspectives
Healthcare Improvement Scotland: Raised repeated concerns to NHS Grampian and stated that inaccurate assurances provided by the health board impacted confidence in the reliability of information received.
NHS Grampian: Chief executive Laura Skaife-Knight admitted failures identified in the reports and commissioned the independent diagnostic review that found serious patient safety issues.
What to Watch
- NHS Grampian's implementation of the 15 requirements and 20 requirements set for Dr Gray's and Aberdeen Maternity Hospital respectively.
- Whether the Scottish Government or HIS escalate oversight of the health board following the findings.
- Achievement of the target to increase midwifery and obstetric training compliance to 90 percent by March 2027.