Stuart McMillan MSP has received confirmation from NHS Greater Glasgow and Clyde and the First Minister that the Intensive Care Unit at Inverclyde Royal Hospital is not closing.
The local SNP MSP put several questions to the health board in light of reports that staff were told on 1 October that the unit was to close. The responses to these questions are included below.
Stuart also raised this issue directly with the First Minister during today’s FMQs. The First Minister confirmed that the ICU at the IRH is not closing.
The questions and answers from NHSGGC are as follows:
Q1. When was the decision taken to close the ITU?
Critical care facilities at Inverclyde Royal Hospital are provided by a team of consultants from a number of specialties and critical care nurses. There is no change to the staffing of IRH critical care services.
We are proposing to build on a patient pathway that was used for certain patients during the pandemic and transfer those who need intensive care support to the Queen Elizabeth University Hospital.
The ICU beds in the hospital remain open. The staff remain in place, within increased senior medical staffing at the weekends. All critical care patients will continue to first be assessed and managed at IRH by the relevant clinical team.
The High Dependency and Coronary Care Unit will continue to treat patients at Inverclyde Royal Hospital throughout their journey. This will continue to include support for breathing problems (via non-invasive ventilation) and circulation support as is the case at present. The vast majority of patients currently treated within IRH critical care will continue to have their care provided in the IRH; based on 2019-20 figures, nine out of ten critical care patients will be treated in the hospital.
Patients who need intensive care support are typically the sickest and their care can include ventilation or multiple organ support. These are also called ICU level 3 patients and require one nurse per patient. Patients who require ongoing multidisciplinary level 3 ICU care will be transferred following admission to IRH.
The Inverclyde critical care services – intensive care unit, high dependency and coronary care – currently admit approximately 1450 patients per year. Within this, the number we propose to stabilise and transfer is approximately 100 ICU patients per year, 7% of total admissions.
IRH ICU staff will manage and stabilise these patients and support their transfer to QEUH. Once patients improve and they no longer need critical care (level 3) support, they will be assessed for transfer back to the IRH for their continued recovery and rehabilitation. This will include access to a specialist critical illness recovery programme if necessary.
Q2. What is the justification for this service being removed?
Keeping patients safe is our top priority and these changes have been made with a view of making sure patients who need the most support have access to it.
Q3. Who took the decision? a) the NHSGGC board, or b) local management?
The recommendation was made by the above group of senior clinicians (ICU Consultants and Anaesthetists), clinical leaders and managers.
Q4. When was the decision communicated to the IRH staff?
IRH staff were informed of the plans to build on the patient pathway on Thursday 1st October.
Q5. Were IRH staff consulted about this service being removed or were they informed it was to happen?
IRH staff were assisting with this patient pathway earlier this year and have experience assessing, stabilising and transferring patients who require critical care level 3 support. They were informed on Thursday 1st October.
Q6. Is it true that NHS consultants have refused to work at the IRH resulting in this service being lost to Inverclyde?
We are not aware of consultants refusing to work at IRH. Our staff at IRH are dedicated and committed to serving the local community.
Q7. Were senior management of the Integrated Inverclyde Joint Board consulted about this decision? If so, when?
We have engaged with senior Inverclyde HSCP staff about this decision as it was developed.
Q8. Did senior management of the Integrated Joint Board express any concerns about this service being removed?
No, they were in agreement that this is a safe model of care, which ensure that the small number of Inverclyde patients who need the most specialist care can continue to receive it.
Q9. When were senior members of the Integrated Inverclyde Joint Board informed of the final decision?
Q10. Using the age groupings as per the National Records of Scotland, how many patients per age range, were treated in the IRH ITU per month in a) 2018, b) 2019 and c) 2020 and how many of these patients were residents of i) Inverclyde, ii) North Ayrshire, iii) Argyll and Bute and iv) elsewhere? (NRS age groupings are 0-15, 16-24, 25-44, 45-64, 65-74 and 75 and over)
A response to this question is yet to be received.
Q11. What is the estimated financial saving to NHSGGC by removing the ITU?
There are no financial savings associated with this change in model of care.