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The Inquiry has published a list of issues that will be covered at the diet of hearings commencing 0n 9 May 2022.  It provides general guidance but It is not intended to be a prescriptive list. The hearings will seek to cover two broad themes: (i) the theory and practice of ventilation in hospitals; and (ii) the background to the project for the Royal Hospital for Children and Young People/ Department of Clinical Neurosciences (RHCYP/DCN).

See full list below or download here.

Scottish Hospitals Inquiry

List of Issues for the Diet of Hearings Commencing on 9 May 2022

This list is intended to provide general guidance in relation to the issues that will be covered at the diet of hearings commencing on 9 May 2022. It is not intended to be a prescriptive list.

The hearings will seek to cover two broad themes: (i) the theory and practice of ventilation in hospitals; and (ii) the background to the project for the Royal Hospital for Children and Young People/ Department of Clinical Neuroscience (“RHCYP/DCN”).

The issues to be covered in theme (i) will seek to introduce the technical requirements for a hospital ventilation system and the role ventilation plays in patient care and safety. The hearing is directed at Term of Reference 1 and adequacy of ventilation. In particular, the functional requirements of hospital ventilation systems and the relevant statutory requirements, guidance and associated good practice. The issues to be covered will seek to introduce the topic and provide context for the wider work of the Inquiry and subsequent hearings.

The May diet will not consider any specific issues in relation to the planning, design, construction, commissioning and maintenance of the Queen Elizabeth University Hospital Campus (“QEUH”) or the RHCYP/DCN. Experts from engineering and infection prevention and control disciplines will give evidence to the Inquiry.

The experts will include Dr Shaun Fitzgerald and Professor Hilary Humphreys. It is important to highlight that the issues to be covered will be relevant to both the QEUH and the RHCYP/DCN.

The issues to be covered in theme (ii) concern the background to the project for the RHCYP/DCN and key decisions taken in the period up to the commencement of the procurement exercise by the issuing of the contract notice.

The procurement exercise itself will not be covered at the May hearings. It will be covered at a separate diet of hearings that will consider the period from the commencement of the procurement exercise up to financial close.

The issues to be covered in theme (ii) are concerned with Term of Reference 2 and, in particular, the strategic definition, preparation and brief, concept design, and financing of the RHCYP/DCN. The governance structures in place at the start of the project are relevant to Terms of Reference 3 and 5. The choice of the site will be covered. This potentially engages Term of Reference 10.

Theme 1 – Theory and Practice of Ventilation in Hospitals The issues to be covered include:

1. The importance of ventilation in a hospital and, in particular, the role it plays in infection prevention and control.

2. The key stages in the development of a ventilation system for a hospital, including: design, installation, commissioning and validation.

3. The key requirements of a ventilation system in a hospital.

4. The parameters in a ventilation system (including pressure, air changes, temperature, filtration, and humidity).

5. Relevant standards and guidance for hospital ventilation systems, including Scottish Health Technical Memorandum 00 “Best Practice Guidance for Healthcare Engineering – Policies and Principles” and Scottish Health Technical Memorandum 03-01 “Ventilation for healthcare premises”.

6. The consequences (if any) of a hospital ventilation system failing to comply with relevant standards and guidance in terms of patient safety and care.

Theme 2 – Background to the project and governance in relation to the RHCYP/DCN The issues to be covered include:

1. The requirement for a new hospital.

2. The proposed site for the new hospital and whether there were any site constraints.

3. How key decisions were made in relation to the project in the period up to the commencement of the procurement exercise, including: (i) the decision to build a new hospital; (ii) the site of the new hospital; (iii) the funding model to be utilised; (iv) the procurement process to be followed, and (v) the utilisation of a Reference Design approach.

4. The development of the Outline Business Case and Full Business Case.

5. The oversight structures in place throughout the business case processes, including oversight of design and design assessment processes.

6. The respective roles of NHS Lothian, the Scottish Futures Trust, the Scottish Government, Mott MacDonald Limited and any other relevant parties in the period up to the commencement of the procurement exercise.

7. The governance procedures that the Scottish Government, NHS Lothian and any other relevant parties had in place for the project in the period up to the commencement of the procurement exercise.

8. The difference between an exemplar design and a reference design.

9. Whether an NHS Design Assessment Process (NDAP) assessment was undertaken in relation to the project.

10. The Key Stage Review process (“KSR”), including, in particular: (i) the purpose of KSR, (ii) what the process involves, (iii) the key individuals involved, and (iv) when reviews were undertaken.

11. Technical advice provided to key decision makers in the period up to the commencement of the procurement exercise.

12. The decision to have multi-bed rooms in the new hospital.

13. The decision to use a “Non-Profit Distribution Model” to finance the hospital rather than capital funding.