‘Excellent’ workers praised but NHS urged to make immediate improvements at Gilbert Bain Hospital
Inspectors find ‘low compliance’ with mandatory training and ‘missed hand hygiene opportunities’
STAFF at the Gilbert Bain Hospital in Lerwick have been described as “excellent” following an unannounced visit by healthcare inspectors earlier this year.
However Healthcare Improvement Scotland has urged NHS Shetland to make a number of immediate improvements across its acute care and maternity services at the hospital.
Inspectors found there was “low compliance” with some mandatory and statutory training in the acute services departments, including in fire safety.
And there was said to be a number of missed hand hygiene opportunities within “several clinical areas”, with some staff not complying with guidance by wearing wrist watches while they worked.
NHS Shetland has submitted improvement plans to Healthcare Improvement Scotland for the requirements made of them across both the maternity and acute services departments.
The unannounced visits on 16 and 17 June 2026 included inspections of the A&E department, renal ward, wards one and three, and the day surgery unit, as well as maternity care.
Staff at the hospital were widely praised by patients, with feedback from patients “overwhelmingly positive”.
“Care was described as ‘super’, with staff being praised for ‘making the renal unit feel like home’ and that they could not do enough for them,” Healthcare Improvement Scotland said.
“One patient inspectors spoke with was reluctant to leave as they felt so well cared for and did not want to miss their favourite meal on the menu.”
Staff were observed to be “working hard to deliver kind and respectful patient-centred care”.
“Patients spoke highly of the excellent care that they had received and of the staff providing it.”
Senior charge nurses were said to be visible and open to engaging, while staff described a “supportive senior management team” that they could escalate issues or concerns to.
Inspectors found that the Gilbert Bain Hospital, which is undergoing major renovations, appeared clean but was “lacking in storage space” and was in an “ageing” environment.
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All areas of the building were said to be “calm and well led”.
However, inspectors raised concerns about a lack of core training among some staff, and identified that some clinical leaders were not getting the time to fulfil their leadership responsibilities because of staff absences.
There were also concerns about the safe storage of chlorine-based cleaning products, with inspectors saying these were “not always stored securely” in the majority of clinical areas.
These products “could potentially be accessed by members of the public or patients” and should be kept in a locked cupboard, they said.
Inspectors also observed five reported incidents of patients displaying aggressive behaviour in the hospital, either against other patients or NHS staff.
That comes after Shetland News reported earlier this week that there had been a rise in attacks on NHS workers in recent years.
‘Appalling’ rise in abuse against NHS Shetland staff condemned
And inspectors urged NHS Shetland to improve hand hygiene across the hospital, saying that “missed hand hygiene opportunities” were witnessed in several departments.
“Within one inpatient area we observed a lack of availability of alcohol- based hand rub dispensers in the patient bays,” they said.
“Several medical and allied healthcare professionals were observed not complying with bare below the elbows guidance with the wearing of wrist watches.
“Adhering with bare below the elbows is essential to support effective hand hygiene.
“Staff told us that patients should be offered hand hygiene prior to their meal, with the provision of hand wipes. However, this was not observed by the inspectors.”
However inspectors reserved special praise for the NHS staff as a while, saying that patients were seen to be “treated kindly with respect and compassion”.
“All interactions between staff and patients were positive with patients speaking highly of the staff and the care they received.
“Ten student nurses provided feedback from their experience of their placement and 100% of these were very satisfied with their learning experience.”
The maternity department was also inspected and found to be “clean, organised and maintained to a high standard”.
“Respectful” team communication was witnessed by inspectors, with efforts ongoing to “support a positive working culture within the unit and improve staff morale”.
While some staff in the unit felt they could raise concerns about understaffing or increased acuity to managers, this was “not the experience for all staff”.
The department was praised for its support to mothers in the isle, with the service “able to be flexible and accommodating to the needs of women and their families living on the islands”.
However several areas for improvement were also required, including a call for a “consistent approach to helping women make informed decisions about their care”.
Healthcare Improvement Scotland said there should also be a standardised method of communication between NHS Shetland and other health boards when there were neonatal emergencies and a mother had to be flown south.
Trauma informed training and bereavement care training for staff were also areas recommended for improvement.
Chief inspector Donna Maclean said they had written to NHS Shetland in July with their findings, with the health board since providing an improvement plan for all the notices served.
NHS Shetland’s director of nursing and acute services Professor Kathleen Carolan said they were pleased that inspectors had recognised the high standard of care being delivered by workers at the Gilbert Bain Hospital.
“We are committed to ensuring that the required improvements are fully implemented and that we continue to provide, safe, effective and high-quality care in Shetland,” she said.
Of the report into the maternity service, Professor Carolan said there was a “clear improvement plan in place”.
“Many of the actions are already underway and we remain committed to continuous improvement and ensuring women and their families receive the highest quality care possible.”
NHS Shetland chief executive Brian Chittick said the report into acute services “reflects the professionalism, dedication and compassion shown by our teams.
“I am pleased that these strengths have been recognised.
“My thanks again to staff for their hard work in sustaining acute services in Shetland, sometimes at the most pressured of times, in service of our community.”
He said the maternity department team were going “above and beyond to make unique connections with the community” every day.
Chief midwife Jacquie Whitaker thanked the maternity team for their support during the inspection.
“The inspectors recognised the kind and responsive care the team provides, and this is something to be celebrated,” she said.
“My thanks also go to the members of the Maternity Voices Partnership and Shetland Sands for their valued contribution and continued partnership in helping us provide safe, effective care that meets the needs of women and families across Shetland.”
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