Health inspectors have called for more improvements at Forth Valley Royal Hospital following an unannounced inspection. Healthcare Improvement Scotland conducted a follow-up visit to assess progress on previous requirements and subsequent improvement action plans, resulting in seven updated or new requirements.
Key Findings from the Inspection
Inspectors observed patients in the clinical assessment unit sitting on high-backed chairs, with some waiting over 23 hours. Patients raised concerns about the length of time they had been sitting, and one patient reported not receiving regular cardiac medication. Staff noted that if there were more than four patients, beds would not fit, and recliner chairs were insufficient for over seven patients.
The inspection also found 20 occasions since December where a patient had self-discharged against medical advice, often due to prolonged waiting times. The report stated: "Patients told inspectors that they were cold, uncomfortable, in pain and one patient raised concerns that they had not received their regular cardiac medication."
Areas for Improvement
The seven new requirements include: ensuring all staff are aware of fire risk assessments and evacuation processes; staff awareness of risk assessments and suitability of patients in contingency beds; safe intravenous line care practices; proper waste disposal and secure storage of hazardous cleaning products; safe storage of medicines, including controlled drugs; and maintaining patient privacy and dignity at all times.
Donna Maclean, chief inspector at Healthcare Improvement Scotland, praised improvements made. She said: "We observed staff working hard to deliver patient-centred care. Staff described a visible senior hospital management team and felt able to raise concerns."
Immediate Actions Taken
Inspectors raised immediate concerns with senior managers, who were unaware of the duration patients had been in the chaired area. The lead nurse attended the unit, spoke with patients, ensured medication was administered, and offered blankets. A new template to communicate the clinical assessment unit status was introduced, and amendments to hospital-wide safety huddles were implemented.
During a return visit on April 7, 2026, patients did not raise any concerns regarding fundamentals of care.
Positive Observations
Despite challenges, inspectors noted improvements in mealtime management, healthcare environment maintenance, and cleanliness of patient care equipment. Two areas of good practice were identified: patients receiving assistance with hand hygiene before meals, and inclusive safety and capacity huddles where staff raised concerns.
One recommendation was made that NHS Forth Valley should ensure discussions about patients detained under the Mental Health (Care and Treatment) (Scotland) Act are included in hospital-wide safety huddles.
Response from NHS Forth Valley
Prof Karen Goudie, executive nurse director, NHS Forth Valley, said: "The inspectors highlighted the work of local staff to deliver patient-centred, compassionate care and noted the areas they inspected were calm and well led despite being very busy. However, they also highlighted some areas for improvement and work is already underway to address the recommendations and requirements outlined in the report."
