Call for Risk Assessment at Queen Elizabeth University Hospital
A comprehensive risk assessment should be conducted across the entire Queen Elizabeth University Hospital (QEUH) campus in Glasgow, according to Andrew Poplett, a leading safety expert who contributed to the Scottish Hospitals Inquiry. Speaking to BBC Scotland News, Poplett emphasized the complexity of determining the hospital's safety status for all patients.
NHS Greater Glasgow and Clyde (NHSGGC) has acknowledged shortcomings at the hospital’s opening and now concedes that certain patient infections were likely linked to contaminated water sources. The health board asserts that the hospital is currently safe; however, families and legal representatives involved in the public inquiry seek further evidence to substantiate this claim.
The Scottish Hospitals Inquiry was initiated in 2019 following multiple deaths and elevated infection rates at the QEUH campus, which had commenced operations only four years prior. The inquiry concluded its hearings in January, with Lord Brodie’s final report anticipated later this year.
Andrew Poplett, an engineer with 35 years of experience in hospital safety engineering research, authored independent reports on water and ventilation systems for the inquiry. Both First Minister John Swinney and NHSGGC leadership have stated that Poplett’s testimony supports the assertion that the QEUH and the Royal Hospital for Children, located on the same campus, are now safe facilities.
However, in an exclusive interview with BBC Scotland News, Poplett described it as
"incredibly difficult to give a black and white 'safe or unsafe' answer"due to the inherent challenges in assessing risk for vulnerable patient populations.
He further advised:
"If you want to reassure the public that this building is safe, do a risk assessment. You don't need to wait for a final report from the public inquiry."
Poplett recommended that risk assessments should be conducted for all wards and maintained continuously to ensure protective measures for vulnerable individuals are effective.
Timeline: The Issues at Queen Elizabeth University Hospital
Poplett acknowledged that while the hospital is currently maintained and operated to a satisfactory standard, the building itself is
"sub-optimal". He expressed surprise that during construction, ventilation rates below recommended guidance for air changes per hour were accepted.
None of the wards at QEUH comply with current national design standards for ventilation. Poplett criticized the design and construction process, stating that
"the right people with the right level of competency"were not involved at appropriate stages.
He recognized the efforts of hospital staff who have worked diligently within the constraints of the building to optimize safety.
"If you've built a building that is suboptimal in design, putting it right is impossible,"he said.
Despite these challenges, Poplett noted that the health board has made improvements to the best of their ability given the facility's limitations. Some specialist units undergo regular risk assessments, but general wards do not.
His report cautioned that comprehensive assessments might necessitate suspending or ceasing certain clinical services.
Family Perspectives
Seven patient deaths at QEUH are under prosecutorial investigation for potential links to the hospital environment, which could result in criminal charges.
Families of affected patients have expressed concerns that the health board and Scottish government have not fully disclosed the hospital’s current safety status.
Gail Armstrong, aged 73, died in January 2019 from non-Hodgkin lymphoma after contracting a cryptococcus fungal infection attributed to pigeon droppings. The ward where Gail received treatment is not subject to annual ventilation risk assessments, unlike another ward on the same floor where air quality has been enhanced.
Her daughters, Sandie and Beth Armstrong, advocate for risk assessments on every ward to safeguard vulnerable patients in general wards. They argue that the health board is circumventing safety standards due to an original agreement exempting general ward ventilation from national guidance compliance.
Sandie stated:
"Our mother died in a general ward which houses leukaemia patients and transplant patients, it is classed by NHSGGC as a general ward. It has been risk-assessed on that basis. But these people are really vulnerable to infection. They need to be speaking in facts, and not in the type of spin that we've experienced for the last seven years from NHSGGC, since our mother died."
Tony Dynes, 63, passed away in May 2021 in the QEUH’s national bone marrow unit while undergoing treatment for non-Hodgkin lymphoma. His widow, Maureen Dynes, revealed that she only became aware of the significance of two infections he contracted—one bacterial and one mould-related—after his death.
In March, the health secretary confirmed the discovery of new mould growth in one of several rooms sealed off in the same unit due to potential water ingress. Last month, NHSGGC proposed constructing a new adult bone marrow transplant unit following a small number of infections.
Maureen expressed cautious optimism about the new unit but emphasized the urgency of immediate action:
"It needs to be fixed for other families so that they don't have to discover this."
Milly Main, aged 10, died after a successful stem cell transplant at the Royal Hospital for Children in 2017. An independent review of 84 cases of unusual infections in paediatric cancer patients concluded that Milly’s infection was
"probably related to the hospital environment."
Following her death, cancer wards at the children’s hospital were closed for an £8.9 million upgrade to water and ventilation systems. NHSGGC maintains confidence in the water quality across the campus.
However, Milly’s mother, Kimberly Darroch, has called for the hospital to be closed. Some families of surviving children treated at the campus report debilitating conditions resulting from preventative medications necessitated by building-related issues.
Findings from the Hospitals Inquiry
The public inquiry into the design and construction of the QEUH campus has heard testimony from 186 witnesses since its commencement in 2020.
Following the final hearings, inquiry lawyers criticized NHSGGC for a lack of clarity regarding compliance with NHS ventilation standards, accusing the board of
"a fundamental misunderstanding of the guidance"after prior assertions of compliance.
While acknowledging
"clear progress"in water system management, the inquiry noted that plans to remove point-of-use filters on taps in some areas could present
"real issues for NHSGGC in terms of maintaining the confidence of patients, staff and the public."
Senior counsel Fred Mackintosh KC and Craig Connal KC recommended a
"rigorous"risk assessment of the entire campus and suggested limiting single patient bedrooms on general wards to four occupants until such assessments are completed.
They also highlighted a
"systematic failure"to heed whistleblowers who raised safety concerns over the past decade.
A senior doctor currently working at QEUH expressed
"ongoing serious concerns."
Lord Brodie’s final report has no set publication date but is expected to take several months.
Health Board Response
In January, NHSGGC acknowledged that some infections were probably linked to the hospital building, most likely the water system, reversing years of denial.
The former medical director testified that the building was
"not built right,"and the board is pursuing legal action against the main contractors.
Current NHSGGC leadership asserts that the hospital is
"wholly safe,"citing rigorous chemical water treatment and routine air and water monitoring exceeding standards at other UK hospitals.
The health board continues to prescribe prophylactic drugs to some patients to mitigate infection risks and has invested £50 million in improvements.
A NHSGGC spokeswoman stated:
"The QEUH and RHC complex delivered in 2015 was not what we paid for. We acknowledge the impact this has had and are sorry to all those affected."
She added that comprehensive remediation programmes are ongoing and safety is actively managed daily. The board conducts thorough water and ventilation testing to provide additional assurance, especially for vulnerable patients.
The spokeswoman further commented:
"We are wholly committed to transparency, with comprehensive information and updates regularly published online, in addition to the creation of the independently co-chaired safety and public confidence oversight group, which includes independent experts and patient family representatives."
