Following a review on Thursday 24th February, NHS Lothian said staff shortages and high demand for healthcare services across East Lothian mean it is not yet possible to reopen inpatient beds at Edington Hospital in North Berwick.
Staff at North Berwick’s cottage hospital were temporarily relocated three months ago in a move to consolidate staffing at the East Lothian Community Hospital (ELCH).
Alison MacDonald, Chief Officer of East Lothian Health and Social Care Partnership (HSCP) said that staffing challenge has not diminished.
She added: “We continue to face significant staffing challenges in East Lothian. Around half (48%) of our registered nursing staff have left their posts since September to work in other roles in the NHS. We have been successful in recruiting less experienced members of staff into the team, but we still have many vacancies (27) to fill to provide the necessary experience and leadership.”
Ms MacDonald explained that grouping more staff in one location allowed more beds to be open overall.
She added: “Transferring the staff means we can keep more beds open overall and look after more people while preserving safe staffing levels. We have been able to open 16 beds at the East Lothian Community Hospital in Haddington, a net increase of 10 beds. We can only do that by having more staff in one place. It allows greater flexibility in how staff are deployed day to day.”
She also acknowledged the decision would disappoint campaigners but she said everything possible is being done to improve the position.
Ms MacDonald said: “As well as our recruitment campaign we are up-skilling existing staff, investing in training and looking at new ways to deploy Associate Nurse Practitioners. We are also working with staff representatives to review shift patterns to help ease pressure. However, despite all of this, we are not yet in a position to transfer staff back to the Edington. We understand this will be disappointing for the local community but hope they will understand we must make best use of our workforce for the whole population of East Lothian.”
Why the decision was taken
- The decision to temporarily relocate staff from the Edington to East Lothian Community Hospital was taken by NHS Lothian Gold Command. This is an operational group which forms part of a recognised resilience structure. It prioritises and manages the response of essential services in an emergency. In NHS Lothian’s case Gold Command is accountable for safeguarding staff, patients and the public and working towards creating patient flow across the whole system including acute, primary care and GP services.
- The decision was taken using scoring criteria, which was agreed with the senior nursing team and staff representatives. The criteria assess the impact on staffing of reopening beds at Edington Hospital and considers the overall bed position in East Lothian and the wider NHS Lothian area.
|1||2||3||Score||Rationale for score|
|Will the return of the bed capacity to Edington hospital at this time help to||maximise||maintain||reduce||the available bed base to NHS Lothian?||3||Opening 7 beds at this time would provide a net reduction of 10 beds available to NHS Lothian. Staffing resource and nursing leadership, and experience registered nursing skills would require to be transferred from ELCH to Edington with no ability to staff or backfill the beds in ELCH. This would impact on the bed capacity within the acute care services in NHSL, a restriction to the flow of patients coming out of the RIE/WGH and potentially exacerbate the current level of delayed discharges across the Lothian system. This would impact on the capacity for NHSL to manage their overall acute bed capacity and subsequently impact upon Edinburgh, West Lothian and Midlothian HSCPs.|
|Will the return of the bed capacity to Edington hospital at this time||maximise||maintain||reduce||the available bed base for East Lothian?||3||Opening 7 beds at this time would provide a net reduction of beds available to East Lothian thereby reducing overall bed complement available to East Lothian and restricting the ability to return East Lothian patients back home to East Lothian.|
|Will the return of the bed capacity to Edington hospital at this time||positively||maintain||negatively||affect the core staffing position across East Lothian||3||Staff capacity would require to be removed from ELCH and at this point in time there are no additional staff resource to back-fill. We are managing to maintain the availability of all wards in the ELCH. We have vacancies and sick leave which has meant a reliance on bank shifts, overtime and extra hours are also explored as a matter of course to sustain safe staffing that supports current beds in ELCH.|
Combining the criteria and rationale descriptor is intended to help Gold Command consider the potential options for returning bed capacity to the Edington hospital. A score in and of itself will not determine the outcome of any decision. A score of 7- 9 is likely to indicate no change to the current position, a score of 3-6 will mean a judgement call may have to be made and a low score of 3 is likely to indicate a return of bed capacity to the Edington hospital.