NHS Grampian needs £0.5bn more to manage ‘failed infrastructure’ — as Scottish Government only funding ‘fraction’ with works at Dr Gray’s Hospital in Moray in limbo
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THE risk posed by NHS Grampian’s “failed infrastructure” has been upgraded to the highest category — with the health board faced with half a billion pounds less than needed for necessary improvements.
A report warned of potential “major failings”, including “structural building failures” like falling masonry, ceiling collapses and ventilation system failures.
As a result, “adverse related events” were more likely alongside an “impact upon staff safety and experience” and threatening “quality and safety of patient care”.
It also warned that, if improvements are scrapped or delayed, buildings could be forced to close and NHS Grampian’s clinical capacity could be hit.
An NHS Grampian Board Meeting heard that financial pressures were driving the “very high” risk.
Board members welcomed a new Clinical Skills Centre at Dr Gray’s Hospital, but Moray’s main hospital has recently been hit with asewage leak that destroyed hundreds of medical records, rodents in the female surgical ward, a critical inspection report and the discovery of RAAC concrete.
The Scottish Government cut the health board’s funding after it announced in January that NHS infrastructure projects across Scotland would be “paused indefinitely”.
After agreeing £36 million of savings, still be to be accepted by the Scottish Government, NHS Grampian had £120 million left for infrastructure spending over the next five years — almost entirely reserved for essential maintenance.
That was despite the meeting hearing that more than £500 million of extra cash is needed, over the same time period, to make its current infrastructure sustainable.
However, the Scottish Government has told the health board that funding is “severely constrained”.
And no decision on whether NHS Grampian can afford to pay for essential improvements to Moray’s mental health unit, Ward 4 at Dr Gray’s Hospital, out of its own pocket has been made.
The risk from infrastructure is set to be assessed again at a closed-doors committee meeting today (April 18).
A new Infrastructure Investment Plan was agreed at last week’s health board meeting, which confirmed that money will now be focused on overdue and essential maintenance, alongside the Strategic Risk Management Report.
And, according to the risk report, “failing infrastructure” has contributed to the most-severe risk facing NHS Grampian - that an “inability to deliver planned and unplanned care” might worsen the population’s health.
The report adds that “this risk is moving in a negative direction and can be considered unstable with existing controls and mitigations unable to allow the positive change or control that is required.”
Board member Dr John Tomlinson said NHS Grampian expected to receive only 18 per cent of the cash from the Scottish Government that it needs to properly maintain its buildings.
“It’s a fraction of what would be needed in a robust strategy,” Dr Tomlinson said.
“I’m just wondering about the ongoing problem that is building up because of that, because we’re doing some maintenance but not a lot.”
Responding, NHS Grampian’s director of infrastructure and sustainability Alan Wilson admitted: “We’ve got failed infrastructure”.
“We need to keep the current infrastructure up to a suitable condition over the next four or five years,” Mr Wilson said.
“Now, everybody on the board are well aware that some places are beyond that, because we’ve got failed infrastructure.
“The money we're getting isn't enough and we need more and we need it quicker.
“So we will be lobbying and we will be pushing for that.”
New Scottish Government rules have ordered health boards to total up the cash needed to make their infrastructure sustainable, with a deadline of January 2025.
Mr Wilson warned that this cost will be “an extreme amount of money.”
“We are sitting in a high risk environment in some of our facilities,” he added.
“And that's a piece of what we're trying to do just now, to keep them safe in an environment suitable for patient care.
“And that will be the challenge over the next two or three years.”
It is understood that, if NHS Grampian decides to pay for Ward 4 improvements with its own cash, money will come from £3.75 million which has been set aside for backlog works.
Also included in this total are essential improvements to the kitchen at Dr Gray’s.
An NHS Grampian spokesperson said: "A backlog maintenance plan is in development and will be presented to the asset management group next month.
“This will look at all our maintenance requirements — including the need for improvements to Ward 4 at Dr Gray's Hospital — and prioritise them against the limited budget available."
