In August of 2014, I left home in Glasgow to visit my mum in Rothesay, despite feeling strangely unwell, which at the time I put down to work-related stress. Two days later, having collapsed on a street in the town, I was diagnosed with acute lymphoblastic leukaemia, so advanced that I wasn't expected to survive.
It was to be almost five months before I lived at home again. I spent most of these months in the old Southern General Hospital and latterly, the Beatson for a stem cell transplant. Prior to the transplant, my immune system was blasted with brutal chemotherapy. I was left not with a 'compromised' immune system, but no immune system whatsoever. Vulnerability to infection for patients like me was the top of the risk assessment list. As we know, hospitals are breeding grounds for all manner of potentially fatal infections which is why blood cancer and transplant patients are on all governments' shielding priorities for coronavirus.
During my long stay in the Southern, the gradual transfer to the new hospital, the Queen Elizabeth University Hospital (QEUH – at that time nicknamed 'Death Star') was underway, including the Beatson's Bone Marrow Transplant Unit: an intensive quarantine ward with purified air. But it was not to be. Even back in 2015, routine air quality monitoring had identified a higher particle count than is desirable for a transplant unit. While remedial measures were explored, consultancy teams returned the service to the Beatson, together with intensively treated acute leukaemia patients – including me.
Grumbling about the new building had already begun in early 2015. For many staff, the design and cost overrode function and effective use of space. Poor design not only related to clinical safety and protection. In the old Southern and the Beatson for example, there were designated spaces on wards for nurses to take tea-breaks and share lunch with their colleagues. Although there is a range of shops for patients in the QEUH, leaving the Beatson to return to it post-transplant, what I missed most was the wonderful patients lounge, designed and built by the fabulous Beatson Cancer Charity, with views across Glasgow, gorgeous armchairs, drinks, snacks and little side rooms for massage treatments. That space was a sanctuary for long-stay patients like me.
Views across Glasgow and beyond are afforded by double-glazed windows in the QEUH. Trivial as it sounds, these views matter for patients. But designers inexplicably inserted cheap venetian blinds between the panes. So, what happens? They break, of course, cannot be repaired easily, so no view.
Despite the humungous scale of the 'super hospital', these important social spaces were not included by the design team. One of the startling things that confronts a visitor to the QEUH, after almost being blown off your feet by the wind tunnel outside the main entrance, is the airport hangar size of the atrium. Why a committee of designers thought that this huge space couldn't have been better utilised as useful clinical and social spaces is a mystery.
Since 2014, there has been a series of problems for the QEUH, including tragic fatalities linked to its design and build. It came as no surprise to me and, I'm pretty certain, to many staff on the front line. An investigation was commissioned.
Sure enough, the investigation report published this week states unequivocally that the risk of patients catching infections was heightened by the QEUH's design, build and how it was maintained: 'While the hospital provides a safe healthcare environment, our findings caused us to focus on those clinical places caring for children and adults with cancers including leukaemia. These specific groups have been exposed to risk that could have been lower if the correct design, build and commissioning had taken place'.
The report also finds it 'extraordinary' that NHS Greater Glasgow and Clyde (NHS GCC) failed to engage an independent engineer to provide assurances about compliance of the building with safety standards.
Heads should roll. One consultant told me that the problem from the beginning was that clinicians, nurses and other relevant staff – the real experts on how a hospital should be designed – were not consulted adequately, if at all. And they should roll because NHS GCC failed to learn lessons from the outbreak of C. difficile at Vale of Leven Hospital, which was linked to 34 deaths in 2008. It's too late for lesson-learning now, and despite the report claiming that it found no 'sound' evidence that there had been 'avoidable' death, the adjective 'sound' is doing far too much work here.
One of the alarming aspects of coronavirus spread is that it is infectious for up to 72 hours on surfaces. In my shielding household, this has led to daily cleaning of surfaces with foul-smelling spray bleach.
Watching The Salisbury Poisonings
this week, a human drama about the novichok attack by Russian agents, a brief line brought home the truly terrifying emergency in 2018 of that toxic poisoning. Tracy Daszkiewicz, the director of public health at Wiltshire Council was responsible for coordinating the response. At a briefing for staff, her team was asked how long the nerve agent would remain lethal to the residents of Salisbury. It could remain a threat for up to '50 years' was the response. Fifty years! How that must strike terror into the hearts of residents, still. Despite all our technological advances, or perhaps because of them, the world has never felt less safe.