Culture the ‘root cause’ of infection problems at Glasgow hospital, probe hears

A microbiologist has told a public inquiry she doesn’t have “reasonable certainty” that problems at a hospital at the centre of infection concerns have been addressed, nine years after it opened.

Dr Christine Peters, who started work as a consultant microbiologist at Queen Elizabeth University Hospital (QEUH) in 2014, told the Scottish Hospitals Inquiry on Thursday that the “prevailing culture” within Greater Glasgow and Clyde NHS was the “root cause” of problems at the site.

The inquiry is currently investigating the construction of the QEUH campus in Glasgow, which includes the Royal Hospital for Children.

You need to have a culture that allows the ground-level staff to openly raise their concerns without it becoming a whistle-blow

It was launched in the wake of deaths linked to infections, including that of 10-year-old Milly Main.

Throughout her two days of evidence to the inquiry, Dr Peters described struggling for years to raise concerns about infection risks to patients resulting from factors including the ventilation and water systems at the flagship hospital.

However she said the culture “prevents appropriate management of whatever risks they are”.

She described having to resort to the hospital’s whistleblowing policy and even directly contacting the-then health secretary Jeanne Freeman in an effort to get her concerns taken seriously.

She added: “Today, as we stand, I don’t have a level of reasonable certainty that these matters have been dealt with.”

She said: “You need to have a culture that allows the ground-level staff to openly raise their concerns without it becoming a whistle-blow.

“We shouldn’t ever need whistle-blows, because we should be able to deal with sincere, hardworking, expert people who run our hospitals, day in, day out.

“They are the eyes and ears on the ground. And if they have something they want to raise, management and others should listen, and that should be the first response.”

She said while she thought QEUH was “a great hospital in general,” she was concerned that the culture would continue to be the “root cause of multiple problems.”

She added: “If it’s not infection control today, it will be A&E tomorrow, so that that is my diagnosis.”

During her evidence she suggested management tried to “minimise” the infection risks and hide the true scale of the problem from the public.

One case she described involved a child who developed Cryptococcus, a rare condition linked to pigeon guano, which was found in rooms containing hospital ventilation equipment that pigeons had been able to access.

Dr Peters told the inquiry that Cryptococcus in children is more usually found in “in high endemic areas” such as sub-Saharan Africa and China , not Scotland.

Every day new patients come into the building, every day the staff are working really hard for the best of their patients

She said management had insisted the diagnosis was a “false positive,” and that they pressured the clinician in charge of the case to “change the diagnosis when speaking to the parents.”

However, she said, the doctor refused and successfully treated it as Cryptococcus, and that a lab in Bristol confirmed that it had been a correct diagnosis.

Dr Peters concluded her evidence by saying that “we expect better” given the the money spent on the flagship hospital.

“Every day new patients come into the building, every day the staff are working really hard for the best of their patients, and we would have expected improvements if we’re spending £800 million on a brand new facility that’s meant to be world-leading.

“We expect better. We expect better rates of infection, particularly because we’ve got nearly all single rooms.

“And that has not been realised, and that’s not fair on the staff who are doing everything else to improve outcomes.”

Earlier she said she had felt belittled by management’s response to her using the hospital’s whistleblowing procedure to escalate concerns about patient safety.

She explained that after submitting her report she was invited to a meeting containing a “galaxy of individuals” from senior management.

In her statement to the inquiry she said: “I was intimidated by the large number of very senior board employees present. I had expected a smaller group.

“The tone of the meeting was set when (board director) Dr (Jennifer) Armstrong cut short my introduction.

“I said I was Head of Department at QEUH for Microbiology, which was the title Professor (Alistair) Leanord had used for the same position.

“She said ‘You are head of nothing. Brian (Jones) is Head of Service just to be clear’. I found this rude, unnecessary, and belittling.”

During the meeting, she said, her concerns were effectively dismissed, and she was given “absolute assurance” about the safety of the water system that she later learned was not true.

The inquiry also heard there was a “staffing crisis” in the infection control team even while infection-related workloads were mounting, caused by staff going off sick, or being unwilling to take on infection control duties.

Dr Peters added that it was “not normal” for staff not to put themselves forward for infection control duties, and that this was indicative of the “unhealthy culture” in the team.

The inquiry also heard that in January 2019 Dr Peters herself had to be signed off work for three months due to the “extreme stress and bullying” she was experiencing from managers.

She related two occasions when she was shouted and sworn at by a manager in front of colleagues, on one occasion fearing she would be physically attacked.

An NHS Greater Glasgow and Clyde (NHSGGC) spokesman said: “These matters are to be explored in the ongoing inquiry and while NHSGGC continues to co-operate with the inquiry, it would be inappropriate to comment on this at this time.”

The inquiry continues.

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