Inspectors warn over cleanliness of Glasgow's Queen Elizabeth Hospital

They found "removable grime" on alcohol-based hand rub dispensers and on panels below wash hand basins in patient toilets,patient cubicles, treatment areas and the sluice room.

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Floors throughout the department were "dusty and gritty" and there was built-up dust on patient monitoring equipment, sterile storage shelving and anaesthetic machines in the resuscitation department.

Contamination was also found on the underside of dressing trolleys, while two patient transfer trolleys, ready for use, were "contaminated with what appeared to be blood", according to the inspection report.

The problems were detected during unannounced inspections by Healthcare Improvement Scotland between January 29-31 this year, ordered by Health Secretary Jeane Freeman after it emerged that patients had contracted infections linked to pigeon droppings at the site.

The inspectors also heard that the hospital was struggling with high levels of sickness absence and vacancy rates among its cleaning staff.

At the time of their visit, there was a 14.5 per cent absence rate for domestic staff, whole one in 10 posts were vacant.

The inspectors state: "Domestic management for the department told us that with the high numbers of patients in the department, it can be difficult to gain access to patient bays to carry out domestic cleaning.

"Nursing staff in the department told us they felt that pressures on nursing time and the number of patients coming through the department each day was the reason for the below standard level of cleaning of patient equipment."

Read more: Boy, 10, treated for cancer was victim of QEUH pigeon infection

Inspectors also criticised "significant gaps in maintenance and improvement of the care environment", with hundreds of repairs outstanding.

They said: "We found a number of areas where the environment was in a poor state of repair. Estates management provided a list of at least 300 outstanding jobs without evidence of a plan to complete these."

The electronic reporting system designed to enable hospital staff to report repair and maintenance jobs also appeared to be malfunctioning, with staff telling inspectors that outstanding estate jobs "can show on the system as complete or can disappear".

The report added: "Staff also said they often have to chase up estates jobs. We were told that delays in completing a job are often not communicated to ward staff.

"We viewed this electronic reporting system as well as paper records kept by some staff. We saw that many estates jobs remain outstanding for long periods of time.

"We saw significant levels of dust in ventilation panels. Nursing staff told us they had expressed their concern on several occasions."

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Inspectors said they were also "made aware of some challenges in the working relationships between senior staff in the infection prevention and control team and the estates department".

Despite the issues with cleanliness and repairs picked up by the inspectors, they also stressed that NHS Greater Glasgow and Clyde is "performing within control limits" in relation to the most common healthcare-associated infections, Clostridium difficile (C diff) and Staphylococcus aureus.

They added that they found evidence of "good staff compliance with standard infection control precautions, including hand hygiene" and "good staff knowledge about how to manage a blood spill and also transmission-based precautions".

Dr Lewis Morrison, Chair of BMA Scotland, said the report should provide lessons "for our whole NHS". 

He said: “A shortage of staff – including infection control doctors – is a theme running through the report and reflects our long held concerns about staffing levels across the NHS.

"There are also apparent and long standing issues with maintenance of the estate. The report finds the fabric of the building is in a very poor state of repair and therefore cannot be effectively cleaned.

"This cannot be acceptable in a modern NHS. It shows the reality of the very substantial outstanding backlog of capital repairs across the whole NHS estate. Equally, it is not something that you can imagine happening in an effectively resourced, adequately funded system.”

Alastair Delaney, director of Quality Assurance at Healthcare Improvement Scotland, said: “Inspectors found areas of good practice in relation to infection control.

"However, there were also areas of concern, such as developing a strategy to ensure the hospital environment and patient equipment in the emergency department is clean and ready for use, and that any estates and facilities issues around repairs and maintenance are carried out to ensure infection prevention and control can be maintained.”

Jane Grant, chief executive of NHS Greater Glasgow and Clyde, said: “The report contains a number of positive findings, including good staff awareness of infection control and high levels of hand hygiene compliance.

"The inspectors have also confirmed that infection rates are within acceptable levels.

“The report has, however, highlighted a number of areas that we need to address.

"Work is already underway to action the requirements and recommendation that Healthcare Improvement Scotland have identified.

“Patients should be assured that the prevention and control of infection has always been, and remains, a top priority for NHSGGC.

“Infection rates in the Queen Elizabeth University Hospital and the Royal Hospital for Children are low – lower than the average rate of infection in Scotland’s hospitals."

The report comes as prosecutors investigate the deaths of a 73-year-old woman and a 10-year-boy, who was being treated for cancer at the QEUH. Both had been infected by Cryptococcus, a fungus linked to pigeon droppings which is thought to have been spread through the hospital's air vents.