Spreadsheet error led to Edinburgh hospital opening delay

A mistake in a spreadsheet set in motion a series of events which delayed the opening of a £150m hospital, a new report has revealed.

Last-minute issues with ventilation prevented the opening of Edinburgh's new children's hospital last July.

A NHS Lothian-commissioned review shows there was a "human error" in a 2012 spreadsheet with the specifications for air flow in critical care rooms.

The mistake was missed in what auditors describe as a "collective failure".

It was only when the hospital had been handed over to NHS Lothian, and £1.4m monthly repayments had started, that independent checks found the critical care rooms were operating with the wrong air flow.

Remedial work worth £16m has since been carried out and the new Sick Kids building started hosting outpatient appointments in July.

But the hospital's full opening date, previously pencilled in for the autumn, is under review in light of the coronavirus crisis.

NHS Lothian said it had already made a number of the recommendations for improvement in the report to "ensure that future capital projects will benefit".

'Collective failure'

A public inquiry into the issues at the Sick Kids hospital and Queen Elizabeth University Hospital campus in Glasgow is also under way.

NHS Lothian asked audit firm Grant Thornton to conduct a review of the health board's role in the Sick Kids project, the first NHS hospital to be built using the Scottish government's private financing model known as Non-Profit Distribution (NPD).

NHS Lothian set the requirements for the hospital but private consortium IHSL designed, built, and financed the facility in a deal which over the next 25 years, including maintenance and facilities management fees, will cost £432m.

The Grant Thornton review concluded there was "collective failure from the parties involved" and that it was "not possible to identify one single event which resulted in the errors".

What went wrong?

The crux of the Sick Kids saga is that the hospital's critical care rooms need 10 air changes per hour to comply with ventilation guidelines designed to control infections.

Complying with these guidelines was in the project contract but the critical care rooms were completed with a ventilation system that only did four air changes per hour.

The Grant Thornton report spells out how this oversight was not spotted.

  • A spreadsheet called the "environmental matrix" and dated from 2012 contained the "four air changes" error for critical care. The Grant Thornton report states: "This looks to be, based on our review, human error in copying across the four-bedded room generic ventilation criteria into the critical care room detail". None of the independent contractors involved in the matrix picked up on the oversight
  • The environmental matrix was then included in the 2013 tendering process where three firms were bidding to build the hospital. One of the three bidders submitted a revised environmental matrix with the correct air changes for critical care but they did not win the contract and the correction was not picked up on by the team evaluating the bids
  • In 2019 a contract row between NHS Lothian and IHSL was settled for £11.9m amidst concerns about the consortium's cash flow, according to the report. However, this "cemented the error contractually" because the "four air changes" error for critical care was written into this deal
  • Another error in the environmental matrix, the inclusion of en-suite bathrooms in critical care, was spotted in 2016 but the air changes mistake was not identified at this stage
  • An independent tester appointed by botRead More – Source
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