Episode 1 Scotland's Superhospital

23 years ago, I was promised

this building would be up and running within ten years.

It's now finally here - enjoy yourselves.

ALL. Yeah!

It's quite a historic moment, actually.

That's it, hen. I'm getting emotional now.

Glasgow, Spring 2015, the Western, Yorkhill...

..the Victoria Infirmary

and the Southern General hospitals are closing.

All four will move into this one, massive, new state-of-the-art

hospital, full of the latest technology.

'Attention, automatic transport.'

It's like an American TV hospital.

Over a decade in the planning,

it's set to revolutionise health care in the city.

And it's finally time to open the doors.

Our doors are locked and we don't have a key

and I'm sure that'll be the only hiccup of the day.

HE LAUGHS

There are mixed feelings all round.

How many years?

43 years.

Oh, my word! Yeah!

A bit sad, actually. I think I would

maybe keep my staff and they can keep their new building.

But how well will four-into-one really go?

54 is full. 55 is full.

Right, so we need to get beds now.

Only time will tell.

Exciting.

Oh, I'm not used to modern stuff.

In the largest operation of its kind ever undertaken in Britain,

four of Glasgow's oldest hospitals are preparing to close their doors.

All four must move hundreds of patients, beds and staff

into this new super-hospital over a period of just six weeks.

The first hospital due to make the big move is

the Southern General, right next door to the new building.

Hello. Ward Four Sister.

Sister Susan Montgomery is in charge of Ward Four.

Today, she is packing up ahead of the big move.

Right, that's fine. Right, OK.

That's OK, isn't it? Yeah, you need... Yeah, 25kg.

You need two people to carry it.

OK, Erin, you couldn't help me carry it down, could you?

I trained here. I've pretty much worked in all of the wards

and it feels like a home-from-home, which is a bit sad, really.

So I'm just going to check your blood pressure again, OK?

It's, it's all been fine but we need to keep an eye on it.

I won't get to Marbella this year!

No.

The buildings are fabulous historical buildings

that are probably not fit for the modern-day health service.

It's a very difficult working environment.

Heating the hot water, the cockroaches,

the constant need of repairs - it's very frustrating

The ambition behind this huge project is to improve health care

in the west of Scotland.

Having large numbers of patients in one place

also makes medical research easier.

There are just six weeks before the new

South Glasgow University Hospital is due to open.

Well, that's wide enough, you, you know what I'm looking for...

At the deliveries entrance, Technical Manager Frances Wrath

is feeling the pressure.

Yes, er, I'm desperate for it, uh-huh.

This is generally every day in here for deliveries.

We have about ?60 million worth of equipment over...

a kind of four/five week period coming in here.

There's 7,500 rooms so everything tends to,

tends to be a big order.

This is our big week where

over ?7 million worth of equipment will come in.

Why we taking all the protection off the fridges at the moment?

Because it means we'd need to bring it back down the stair.

Aye, but we've got a scanner coming in today at 11,

so what I need is this area kind of clear.

The scanner which is coming in today is a cardiac scanner

for our children's imaging department.

I think it's the first of its kind in Britain.

It's cost us about ?1.4 million in total.

Brand-new, state of the art.

It's always a worry it'll get under the door.

The internal door's the lower one, isn't it?

You can drop that.

Right, are we going to manage it?

NOISE DROWNS SPEECH

Yeah.

Just this bit here at the end.

In just a few weeks, every single patient

from the old Southern General must make the move to the new hospital.

The speciality with the most patients will be

the Respiratory Department.

Lung disease is one of the biggest health

problems in the west of Scotland.

So what do you think - chest infection?

A fact consultant Kevin Blythe deals with every day.

Hi, Mrs McNeil.

Kevin's patient Catherine McNeil has lung cancer, a disease this

region has a higher incidence of than any other part of the UK.

We're obviously having a look,

just to try and establish for you

whether this tumour has spread into the lining of the lung, OK?

And will I be in overnight tonight?

I think when we spoke to your husband last night, we thought

we might keep you overnight. I think he's hoping you might, aye.

Is he? Do you think he's got a party planned?

A wee bit of cold stuff.

I was appointed as a consultant here in 2009,

so it's been about six years.

Is it still cold? No, it's fine now. It's all right now.

'Mixed feelings, I think, about moving.

'I've a bit of affection for the old place.'

It's not just lung cancer that keeps the unit busy.

Glasgow's industrial heritage has left the population with

some of the highest levels of asbestos-related respiratory

diseases anywhere on the planet.

We've a large proportion of beds in this hospital

and we have a large proportion of beds in the new hospital

and that really reflects the amount of disease.

In the Southern, we have about 36 chest patients

at any one time.

When we move into the new hospital

we will have the entire seventh floor,

which is 112 beds.

The new chest unit will have 17 consultants

and will account for a tenth of all in-patient beds in the new hospital.

This hospital will bring maternity, adults' and children's

services all together onto one site for the first time in Glasgow.

One benefit of this will be that babies can be kept on the same

site as their mothers if problems arise during birth.

Once all four hospitals have moved into the new site,

a workforce equivalent to the population of a small town

will care for hundreds of thousands of patients every year.

The new building has the largest floor space of any hospital in the UK.

Coming up with a design that was fit for purpose was a huge undertaking.

The task fell to a large firm of London-based architects

with an expertise in hospital design.

Neil Murphy led the team.

It is, you know, as I understand it, it's the biggest one built

by the NHS and the biggest one in the UK.

It's pretty major, you know.

Nothing that takes five years ultimately to physically build

is a small project.

The design was inspired by Glasgow's ship-building heritage.

The 12-storey adult building the dock,

to the children's hospital ship.

The main building centres around a vast central atrium which is

large enough to fit a jumbo jet inside.

The bottom three floors of the adult building house all the acute

services such as A E and theatres.

The wards are arranged over the top eight floors.

In terms of the adult tower it's quite a welcoming building.

It's quite open, open-armed.

Hospitals are very, very complex

and what we were keen to do was make this building

a building that was very, very easy to find your way around within.

Art has been used at key locations in the hospital

to help visitors find their way around.

The building design plays its part, too.

With round windows used in doors inside the children's hospital

and rectangular in the adults.

It was very, very important to the NHS

that we created an environment that wouldn't stymie them in the future.

So they can shift the number of beds on how they nurse it

and how they look after and how they monitor their patients.

The new hospital is being fitted with all the very latest kit.

From wireless-connected TVs in every room

to pneumatic tubes transporting blood samples.

In the basement, robots will carry food, drugs and equipment

via designated corridors and lifts.

This is a hi-tech hospital built for the future.

ROBOT. Attention! Vehicle changes...

When the hospital opens,

the first arrivals will be to outpatient clinics.

Today, a group of volunteers have been brought in

to test how easy it will be for them to use some of the new technology

and to find their way around.

And today, we're really asking you to come in as guinea pigs

and throwing you in the deep end to try out

some of our patient appointment system.

We've got some self-check-in booths that we want you to try out.

I'm Margaret, I'm the sister from outpatients. Oh, right.

Looking forward to it.

I think there's a wee bit of apprehension, as well.

Obviously, you want everything to work.

I always say we're the shop window to the rest of the hospital.

If this is your first experience of a hospital,

we really need to get it right.

I think it's this way.

That's me.

A Therapy. Do you think that means something?

Go down there. You'll be down there. B. B.

There's another floor over there.

We're lost. Hah!

Um...we should be here.

They need more signs, definitely,

because the signs that were there,

they didn't match where it actually was.

From operating theatres to toilet cubicles,

every inch of this vast building has been scrutinised by medical teams

who worked closely with the architects.

From day one, Consultant Sandy Binning

has been involved in the design of the brand-new Critical Care unit.

It will be by far the largest in Scotland.

We've designed it so that we've got some open areas

and we've got some smaller areas that allow some privacy.

So we've got a two-bed area here

and we've got five beds straight over

and then we've got some side rooms

for patients who are an infection...infection risk.

For Sandy, the top priority was that the majority of the unit

would have large open-plan areas

with good sight lines for nursing staff.

A lot of our patients have problems with their brain.

They are often... They're not themselves. They're often agitated

and they can cause self-harm.

We've got, um... The patients often have a lot of tubes

in different parts of the body

and when they're agitated, they can pull these out.

Particularly their breathing tube.

And so it's very important

we have a really good view of our patients at all time.

The sheer scale of the new unit will solve a major problem for Glasgow.

One of our main problems is that we are four hospitals

and we don't always have space in beds

in each of the hospitals at the right time,

so we're avoiding a lot of transfer of patients around the city.

So all our patients are going to stay in the same site.

Back at the Southern General,

there are just ten days to go before the wards will close.

Can I have a wee chat with you about Sunday? Yeah.

Do you fancy coming in to help me?

I was thinking you and George... Do I need to?

I need you. OK, fine.

In Susan's ward, patient Thomas Scott knows the old hospital well.

Most of my family were born down here.

I was brought up in Govan, so I'm a local.

Well, I've been in for seven weeks now.

And I've been told I more than likely need to be going over there.

With the exception of the Critical Care Unit,

the wards in the new hospital will all be ensuite single rooms.

This decision was made in consultation with patient groups.

It will mean huge changes for nurses.

You can stand at a nurses' station in any ward and get a real sense

of what's happening with the patients.

You know, what the sense of the mood is.

That's going to be very different in the new building.

Moving to a ward with 28 single rooms

will make ward rounds harder for nurses

as every patient will have to be visited individually.

Today, Susan has brought her team to the new hospital

to prepare for the adjustment.

Right, guys, shall we go and find a hoist, a regular one,

and then we'll put Karen in it?

So this is a medium sling. LAUGHTER

How's that? I'm sure that's fine, Karen.

'So, is it different from what we're used to?'

'Yeah, I think there is probably a fear of the unknown

'among the nurses at the moment.'

Moving from a Nightingale-esque ward to all single room accommodation.

It's something that, you know, we're not used to.

It's an entirely new nursing model.

I was worried when I first used it that I would squash the patient.

Argh! Oh, Karen, just relax. It's fine. There you go.

Whoo! OK?

That's fine.

Oh, now I know how the patients feel! That's good.

Deep down, I would say that I'm confident

that it's all going to go smoothly, you know.

When I talk to my staff about what's happening,

I think I'm filling them with confidence.

That must be coming from somewhere!

That wasn't pulling on your legs or anything, Karen?

No, no. It was fine.

Yeah. Obviously, if it was a real patient, we'd be giving them

lots and lots of reassurance, but it's just Karen.

LAUGHTER

At the Southern General, Kevin is about to carry out

his last ever procedure here.

This is the Endoscopy Unit, where telescopic cameras are used

to look inside different parts of the body.

This used to be the eye theatre at the Southern.

It's a theatre, rather than an Endoscopy Unit,

which is a slight difference.

Much like the wards, it's kind of been renovated to...

to function in modern medicine.

Um...it has its challenges.

We quite often come in to find the heating's broken

and we have to delay our cases by an hour or so

to get the heating working again.

That kind of happens once a month.

You're not allergic to anything, is that right?

Kevin's last patient is 78-year-old Peter Daniels,

who has fluid on his lungs.

Which points to a suspected tumour.

We're going to do a thoracoscopy,

which is a telescope that we're putting inside his chest.

So he has miscollection fluid in his chest.

And so we're going to try and relieve his symptoms

and get him a diagnosis in the one sitting.

I've actually got hot water. That's very unusual.

If we try and get through this gap and look here,

all the red-stained abnormality there

is very likely to be a tumour.

So we'll try and take some biopsies from here.

Thoracoscopy is a very specialised process

used to help swift diagnosis of lung diseases.

Kevin and his team have been performing the procedure

together for five years.

Could you get a chest drain? Mm-hm.

'We're moving to the new Endoscopy Unit,

'we're going to have different staff.'

Kevin's current team work at more than one hospital.

And the service here runs just once a week.

The new building will have a dedicated Endoscopy Unit

which will be staffed fulltime.

Not entirely reassured that it'll be better than it is here.

It might be more difficult for a time, I think.

I'm quite sad it's our last ever one, so... But carry on.

We'll teach somebody else and they'll be absolutely great at it.

A bit sad, actually. I think I would maybe keep my staff

and they can keep their new building,

but, er...we'll, er...we'll manage.

It's the weekend before the first outpatient arrivals.

And throughout the hospital, staff are preparing

to get the new building ready for the public.

For commissioning manager, Karen Connelly,

it's a moment she's worked towards for years.

Well, this desk, for the past 13 weeks has been used for

our security team signing everybody in and out of the department.

But as of tomorrow, it's a fully-operational reception desk

for our patients and visitors coming in.

So I just need to get it looking like that.

ROBOT. Attention, automatic transport!

It's now programmed, OK?

I think that's a mistake.

Well, I've been in since 6.30 this morning.

We were here until 8.30 last night.

We're going to probably be here until about 8.00 tonight.

So it's been a long weekend for us.

Today, the first patients will finally walk through

the doors of the new hospital.

We've waited about 15 years for these patients.

And it's all about the patients this, er...hospital.

It's a wonderful day. It's a great day.

It's really, really big.

It seems like a big, grand palace.

Oh, it's amazing.

The architecture in it is absolutely fantastic, you know.

Every time you look up, it's just a different experience.

It's a completely different vibe.

Now it's a hospital, it's no longer a construction site,

we're fully... well, not fully operational,

but we're operational now and it is a hospital, so

that's what we were aiming for.

The second of the four hospitals due to move

is the Victoria Infirmary.

It has the smallest, but one of the busiest

Accident and Emergency Departments in Glasgow.

Hi, there. I'm Mel. I'm the nurse in charge tonight.

Just having a wee look around to see who everybody is.

Senior staff nurse Mel White has worked at the Victoria

since the early '70s.

I've been in the Victoria since I was...17.

I am now 60.

And...I know this place so well

because as a night sister, we used to

wander around the wards all night long.

And I've just got such a great fondness of it.

We've got patients all over the place in this department.

'I usually like, if I can get the chance

'to have a wee look around the department...'

Hello. Hello. I'm Mel.

..and put faces to conditions.

And make sure they're all being looked after correctly.

INCOMING CALL Excuse me.

Mel has seen a lot of changes to A E in her 43 years.

'Accident and Emergency was known then as the back door.

'It wasn't a specialty.

'And we didn't see anything like the numbers we see now.

'Most of the GP patients went straight to the wards.

'Whereas now, they all come through A E.'

I've got a bed for you in Ward 12A.

Just the other night, we were so overwhelmed with patients,

we had nowhere to put anybody.

A lot of the patients nowadays are very elderly

and there aren't enough of us to look after the patients

as they should be.

We have to prioritise the jobs we do.

Part of Mel's job as nurse in charge

is to keep an eye on waiting times in the department and file reports

if people wait longer than the government target of four hours.

It's a job she will be doing in the new hospital, as well.

And we've got little clocks on each patient.

When they go black, it means they've been here more than four hours.

So I've got to take a wee note of all these patients

and find out the reasons why they've been delayed.

Sorry.

Two going to... Two going to surgery?

The gentleman up in Room Six.

One of the biggest changes at the new hospital

will be the way emergency patients are dealt with.

Instead of all emergencies coming through the doors of A E,

people referred by their GPs

will go to a new area in the hospital.

The intention is to reduce admissions and shorten waiting times.

I'm excited because I do... I'm hoping it'll be more trauma-related.

The GP patients are all meant to be going to another area.

So I hope it might be more like the A E

that me and some of my older colleagues signed up for originally.

In emergency medicine, speed of treatment is often critical.

The crowning glory of the new hospital

is an enormous rooftop helipad

designed to ensure patients reach A E as fast as possible.

Today, Emergency consultant, Phil Munro,

and Commissioning manager, Karen Connelly,

are waiting for the first test landing of the Air Ambulance.

This helipad will see hundreds of landings come in

from all over Scotland every year.

Here's hoping there were no pile-ups on the M8.

THEY LAUGH For the first one coming in!

At the old hospital, patients are dropped in the car park

and then taken by ambulance to A E.

The helipad will vastly improve patient transfer times.

Once it's fully up and running,

patients will be taken straight to the Emergency Department

from the roof via a ramp and high-speed lift.

We're looking at reducing the transfer times down from,

perhaps, 15 or 20 minutes minimum

to less than five minutes,

and making that whole process

much simpler and smoother for patients,

so it's actually pretty exciting for us.

We've still got, obviously, a night-time one to do, and we've

started communication going with the Search and Rescue guys.

HELICOPTER BLADES WHIR

SIRENS WAIL

For the helipad to get its final sign-off,

there must also be a test landing at night.

HELICOPTER BLADES WHIR

Tonight, the team are back on the roof,

to see the Royal Navy Search and Rescue Service -

who carry out land and sea rescues -

land their huge Sea King helicopter on the roof in the dark.

Now that's, sort of, all our approvals reached

so the helipad is now ready to go operational.

This was the last box ticked.

HELICOPTER BLADES WHIR

It's the first weekend of May at the new hospital.

After years of planning, the big day has arrived.

So, I'm Anne Harkness, I'm Director of Medicine,

so I'm co-ordinating this weekend.

OK, the plan today is to move the Coronary Care Unit,

the Receiving Medical Unit, Ward 20,

and Wards 22 and 25.

To move Ward One, Two, Three, Four, Five and Six,

and the Emergency Department will move.

In the old Southern General,

everything is ready for the big move.

The meds are done, the CDs are done...

Over the course of the weekend, almost 200 patients

will be moved into the new hospital.

Hundreds of empty beds await their arrival.

The patients from Critical Care will be the first to be driven

the short distance to the new hospital by ambulance.

Dr Sandy Binning and his team are waiting to welcome Norma Silvers,

who will be the very first inpatient in the whole hospital.

This is a piece of history within the NHS in Glasgow, yeah.

The staff seem excited.

They just want to get started, I think.

That's great.

You see patients being transferred every day of our career,

and it's just, it's just really exciting -

quite emotional, actually.

Hi, Norma! Hi, Norma!

With the first inpatient safely settled into the Critical Care Unit,

the huge task of moving the rest of the hospital gets underway.

Accident and Emergency provides care around the clock.

At the old Southern General, the staff are preparing

for the exact moment the brand-new unit will take over

and their doors will be closed for good.

It is approximately seven o'clock just now

so we've got another hour to go.

We're still a fully-functioning Accident and Emergency

right up until eight o'clock.

At 7.59, the last patient is allowed to book in,

and at eight o'clock, the new department opens.

Locking a door that has been open for decades

isn't without its challenges.

At the moment, we've found two boxes of keys that look decidedly old.

We've found the old College of Nursing door key -

the College of Nursing ceased to exist in 1980-something.

Christine, as the longest member running of the team,

would you like do the honours and lock the department up?

For the first time in its history,

the doors of A E at the Southern General are closed.

It feels quite emotional, actually.

I wasn't prepared for this.

Over in the new Emergency Department,

the team are about to open their doors for the very first time.

Did you make a decision? Are we ready to open the doors?

We need the standby radio here,

and once that's here, we're... We'll be ready to go.

Yeah, so the theory is, we open the doors at eight o'clock.

So, I started as a consultant in the Southern 23 years ago.

I was promised this building would be up and running

within ten years.

It's now finally here. Enjoy yourselves.

LAUGHTER

Say cheese!

There you go, guys. Yeah! Thank you very much.

As the emergency teams await the arrival of their first patient,

up on the ninth floor, Susan is doing her best to get her

new ward ready for the arrival of her first patients.

I... No...

I need them today. David, I can't...

I need more. One pod key.

It's just the master key for the...

The patients' lockers - we call them pods -

and basically, all the patients' individual drugs

go in these pods, and at the moment,

the wards have only got one single key for 28,

you know, to cover 28, and we're...

You know, we work in teams,

and that's really an impossible situation.

Over in the old building, Susan's staff are being

kept on course by Lead Surgery Nurse Pamela McQuarrie.

It could be that, at a moment's notice,

the command centre advise us to tell you,

"Your patients are moving now."

Are you ready for the big move?

Well, we'll see if it lives up to...

Hundreds of extra staff will be on duty all weekend to ensure

patients are monitored throughout the move.

Everyday business, like this doctor's rounds, must also carry on as normal.

So, you've got two people still to do? Yeah, it's transferring...

Can you put it...? Yes. So that's prioritised,

and it's getting done now.

Everything is static, which is exactly what we want.

Notes - if you could get the notes to the end of the bed

so that we're all ready to go?

How are you? Fine, I'm lovely.

Good. Great, that's all looking good.

Are you ready for the move?

I'm quite interested to see what like it is.

I hope it's money well spent.

Sheena, can I take you aside a wee second?

Two wee seconds...

I need an escort with him, but he'll be fine.

He's just had a set off him,

and he's definitely to go to ARU just now.

OK, and is he going in a chair? Yes.

So, is he...? With oxygen.

And somebody's putting him on the chair?

He will be going on the chair in a minute. OK.

Bye. Okey doke, that's us off.

Wait a wee second, and let me get tablets. No, no, no, no. No.

You go back to doing what you're doing...

In one short ambulance journey,

the patients from Susan's ward

will move from the 19th to the 21st century.

It's some place, huh? Oh.

Aye, it's massive.

See, I thought I was at the airport.

Aye, it's the departures lounge, though, isn't it?

Where are we going, Tenerife?

The first patient's coming in, so we're just preparing the nurse.

Hello. Welcome! Thank you.

And how was the transfer over?

Aye, it was OK. Obviously, it's a logistical nightmare.

What am I going to watch?

I'll watch the snooker because all the rest is rubbish.

'It's like going into a five-star hotel.

'It's all mods and cons.'

I'm just still getting used to the TV.

You know, things like that.

Well, I'm only in, so

I've not taken a shower or I've not used the facilities,

but everything's there for me.

Back in Ward Four, the end is in sight.

We're lucky last.

Yes, they've left the best to last.

Left the best to last.

I'm looking forward to it, definitely, yes. I really am.

For the nursing staff, the departure of the very last patient

marks the end of an era.

Bye! See you later, Mr Scott!

Well done, folks. All right.

What's happening with...? Oh, he's getting a cheer.

Rebecca... There you are. That's it all, hen.

'Strange seeing the ward empty, though.'

It'll be weird...

but it needs a change.

I'm getting emotional now.

Are you, hen?

Uh-huh, it is.

'I was actually born here,'

there's never been a time when there's been

no patients at all in the whole of the building,

so it's quite a...

It's quite a historic moment, actually. PHONE BEEPS

Thomas is the last patient to come in from Susan's old ward...

Are you OK there, sir? Yeah.

..and his arrival signals the beginning of a new chapter.

All right, Thomas, we've got you here in one piece. Yes.

You know, you're the last patient to arrive -

we've all been waiting for you.

I'm just amazed at everything, you know, all around me there.

I'm just... Awe inspiring, it was.

The last patient's just arrived, and he told me he had a...

he had a guard of honour as he left Ward Four.

'You know, this is the important bit that's been done -

'the patients are here and they're all safe.'

VOICE FROM TELEVISION. Couldn't have played that any better.

APPLAUSE

He was updated to me at about 30 minutes out. Is that OK?

Six hours into the first shift in the newly-opened Emergency Department,

and the team receive a call

to say that the first air ambulance is on its way.

He probably has significant chest trauma,

so it's either equivalent flight to Raigmore with no tertiary input,

or here, so it gives us enough time to be able to do that.

Is that all right?

It would appear to be a motorcyclist.

I think a Belgian motorcyclist, who's come off his bike at speed,

so we're just making the arrangements to make sure

that all the things are in place to make it

a smooth transition of the helicopter landing,

through into resus, to make sure there's no other interventions

that we need to do that might have changed since the roadside.

Come on, let's go...

Consultant Cieran McKiernan is headed to the roof with

Senior Staff Nurse David McGlynn to meet the air ambulance.

First patient, first minor,

first standby, first intubation,

first helicopter with a real patient.

So...

I'd like to think it's cos I was the best that I got chosen to do it,

but I think I was just the last to put my name down for annual leave.

And Karen and the hospital firefighters are on hand to

support the medics.

This hospital covers over 40% of Scotland's population.

When it comes to suspected neural and spinal emergencies,

it covers the entire country.

This patient has been flown 200 miles from Plockton in the West Highlands.

HELICOPTER BLADES WHIR

As soon as the helicopter has landed,

he is whisked straight into the lift.

Belgian motorcyclist Christof Leveveran

was found with a serious chest injury

and initially treated at the roadside by air ambulance doctors.

A motorcyclist travelling on a single-track road has, I think,

struck a rock, landing face-first onto head, and left side of chest.

This injury occurred approximately four hours ago. OK.

When we arrived, he had a GCS of 15,

was moving all four limbs,

but had clear respiratory difficulties.

Pretty good colour, he's got good count refill.

Pupils are small and reactive.

I think we're that far, timing-wise, down the line.

I'm pretty happy to top him, do you want me to stick a...

The team will stabilise the patient,

and check to see if he has any

immediately life-threatening problems.

Propofol is running, 50 of Roxin,

chest drain's in, heart line's in,

bloods are away.

Cieran, you agree with me, he's not likely...

he's not going to be likely to need to

go to theatre prior to scan? No, absolutely, yeah, no, not at all.

So the plan is tidy up and pan-scan? Yeah.

Historically-wise, we would've done a whole series of X-rays

to see if there was any injuries,

but given the fact that we're now in this big new hospital,

we have a CT scanner.

We have several CT scanners about 50 yards away,

so we've arranged just to go straight for a scan, a CT scan.

All right? Yeah.

The hospital has been designed so that A E is close to other areas

necessary for the treatment of seriously ill patients.

This means the sickest patients should be diagnosed

and treated as quickly as possible.

Christof has a full body CT scan which reveals no further injuries.

Three hours after arriving at the hospital,

the first air ambulance patient is admitted to the Critical Care Unit

on the second floor.

It's the first week at the new hospital,

and Dr Kevin Blyth is in his brand-new Respiratory Ward.

I think everybody's... everybody likes their setting,

everyone likes the environment, everyone likes having TV.

We're lost most of the time so it's,

kind of, lots of wandering around.

What was that?

Kevin's patient Catherine McNeil has come in to have some

further tests for her lung cancer.

This is...something else.

Like a hotel.

En-suite, everything.

It's absolutely lovely.

How are you? All right...

Catherine already knows that her cancer is advanced.

Today's procedure will help her to decide

whether to have further treatment.

I know we've spoken about this before,

but do you know roughly what we're going to do today? Mmm-hmm.

OK. Not too much information, please. No.

I won't give you too much, just enough so that you,

you can sign the form.

I have discussed with my husband funeral arrangements.

I have cleaned out my wardrobe.

I got rid of the clothes I don't need.

Erm...

If I don't do that now, somebody's left at the end of the day

to do it all.

Where do you want it?

What we would, it would be good to have,

see if we can have the trolley in here? Uh-huh.

Catherine's procedure will take place in

the new purpose-built Endoscopy Unit,

which Kevin and his new nursing team are still finding their way around.

'We have all these...' That's a new one, yeah.

'pieces of kit that we didn't have before,

'but there other benefits.

'Clinical research is a major priority for

'quite a number of us in Glasgow.'

Geoff, can you pop that screen round?

'But actually delivering...'

that expertise, and delivering trials, in patients

who are scattered in half a dozen or more places, is difficult.

'And that's going to be quite a lot easier to do

'in a big centre like this hospital.'

How are you doing? Are you OK? Aye.

'And our own unit's main focus is in detecting disease better,

'earlier and more efficiently.'

Early diagnosis, particularly for cancer, can be life-saving.

For Catherine, the hope is that the right treatment

may prolong her life by a few months. All right, OK...

Kelly, that's white...white balance.

Are we on? Can we just...?

It says "DF is not connected" or something.

It's not connected properly.

Do you want to just take the scope out and reconnect?

That's the problem with new equipment.

Well, we did... Well, we didn't...

Just turn it off. Turn it off. Yeah, turn everything off.

OK, turn it back on.

Try again.

Yeah, done. Is that it?

Sorry about that, Mrs McNeil, technical failure,

but we're good to go.

'The question that's now being posed is whether the cancer has

'spread out of her lung into the glands and the centre of her chest.'

Let's see if we can get a sample there.

MACHINE HISSES OK, good.

That's essentially some tissue from inside the gland,

that we would then send, and see if...

if that has cancer cells inside

or whether it's just inflammatory stuff.

And then we just...

Samples like these are sent straight

to the new laboratory across the road for analysis.

Miles of pneumatic tubes run from wards and departments

throughout the hospital,

connecting them to this huge facility.

When the hospital is fully up and running,

a huge workforce will process and analyse thousands of

specimens and samples here, round the clock.

MACHINE RATTLES AND BEEPS

It has one of the largest automated systems for analysing blood samples

in the world,

and aims to turn urgent results around in less than an hour.

Back at the Victoria Infirmary,

it's Mel's very last night shift in Accident and Emergency

before the whole hospital closes at the weekend.

It's looking, actually, OK just now. It's not too busy.

Busy is when we completely run out of space,

and they're queuing up the corridor with ambulance patients,

but we'll see.

That happens frequently in here,

cos, as you can see, it's a very small department.

We don't have an awful lot of room for things. Hello? Hi, guys...

So, carry on.

I felt really sad before I came in tonight.

I shed a wee tear on my way in, but I've got too many distractions

just now, so I think once we get all this cleared, hopefully...

I might have time to think about it a wee bit more.

This chap, man, said that he's just to...

'I've only had one visit to the new hospital and it's like something

'I never thought I'd see real.'

It's almost like an American TV hospital.

It sounds very good on paper,

but it's going to be covering such a huge area,

that my concerns are that the majors area won't be big enough.

As usual on the night shift at the Victoria,

it's waiting times that preoccupy much of Mel's time.

Yes... We've got quite a few round in the minors still waiting to see

the surgical on call,

but he's busy up in the wards with somebody that's very unwell,

so that's all a wee bit of a stand-still,

and they're the ones that are all over four hours now because...

and that's one of the reasons that we can't help.

I came in about 9pm, and it's now nearly 11pm...

but there's always people who are iller than oneself, so...

Yes.

'If you don't tell people what's happening and why,

'they obviously get very angry,

'and a lot of the time,

'people just don't accept the reasons we give them,'

and they do get very cross with us.

They get quite abusive, some of them,

but it's because they're concerned about their relative,

and I think I would be inclined to be the same.

If it was my 80-odd-year-old mum lying on a trolley for six hours,

I would be annoyed.

So we've got to be very diplomatic at times,

and we ply them with cups of tea.

I always tell people, when they've been here four hours,

their reward is a cup of tea and a sandwich.

PHONE RINGS

Over the years, Mel has seen the types of patients coming to A E

change dramatically.

Traditionally Friday, Saturday nights were always bad,

cos of fights and stabbings,

and all that sort of thing that we used to get.

We get a lot more elderly now with multiple medical problems.

Payday, payday's usually a... Payday's a bad day...

..is a bad day for us because everyone has money to go out and...

Get bevvied. ..take substances,

whether it's alcohol, heroine...

Cocaine. Erm, cocaine...

And all those other fancy...

Crystal meth. Crystal meth. MDMA.

It's...

Payday's a bad day. Payday is the day we don't like in A E.

Still at 16 patients,

but I think most of them are round in the plaster room

getting attended to round there,

and the surgeons are here at last.

Cough. SHE COUGHS

OK, and a wee cough again.

SHE COUGHS

As the night wears on, the final shift is proving to be

a relatively quiet one for Mel and the team.

Yeah, I'll just hand over...

Sorry, I was just going to say, take, take...

Use room five, yeah.

Can you bend the knee for me? Yes.

Mr Buchan, you are our very last patient,

and we're all here, with a wee cake,

for a cup of tea when you get up the stairs.

I hope you're not diabetic?

CHEERING

Bye! Bye-bye!

CHEERING

Turn around.

Cheers, everyone!

THEY CHEER AND CAMERA CLICKS

WOMAN LAUGHS

Well, that's it done.

CHEERING

Time to go home.

Oh...

How many years?

43 years. Oh, my word.

BBC NEWS THEME PLAYS

Tonight on Reporting Scotland,

claims of chaos at the country's new "super hospital".

Just weeks after opening, people wait hours to be admitted to A E

at the new Southern General in Glasgow.

Just three weeks after opening, things are not going to plan.

The pressure of staffing both the old and new hospitals

is putting a huge strain on staff.

The aim to reduce waiting times,

by separating patients referred by GPs from those coming to A E,

isn't working.

Hundreds of people are waiting well over the four hour target -

some as long as eight hours.

We had some real problems in the first week or so, in making sure

that patients who'd been referred by their GP were seen quickly enough.

There are always peaks and troughs in the demand for

emergency admissions and we have to be able to cope with that.

Up until now we've been trying to provide services

on two or three sites...

We've been trying to run as best we can on new models of care,

but really, we haven't had enough resources to do that.

Reports of the problems go right to the top.

Is the Minister comfortable with

the reports in the press today of mayhem

at the Southern General Hospital Accident and Emergency Unit?

While NHS managers work out how to solve the problem,

Mel's heading in for her very first night shift at the new hospital.

I've only seen bits and pieces in the papers,

and I'm not really surprised,

because I don't think...

other than the people that actually worked in the Victoria,

how busy it was, what a busy place it was,

and the huge volume of patients we saw there

in such a small department.

to the people that worked in the Southern General,

of the numbers coming in.

We were seeing 200-and-odd some days at the Vic,

in a place that's probably half the size of this one.

Mel began work at the Victoria in 1972,

so tonight marks a huge change for her.

Very mixed feelings really.

A wee bit nervous about it,

but I know how to do the job and look after people,

and that's what it's all about, really, isn't it?

So we'll see...

We'll see what happens tonight.

I hope they don't make me nurse in charge, though,

on my first night, because I think that would be cruel.

It's not only in the emergency areas

that the first few weeks have been difficult.

Settling into the new wards has been hard work for nursing staff.

So we've got eight admissions today, Rebecca?

Uh-huh.

And they're all same-day admissions, so they'll all be coming post-op,

and I've got one bed, with four going home -

possibly four going home.

Possibly post-op? Post-op, yeah.

In their new ward, Susan and her team have been putting in long hours.

We were the first people in, and it was really, really difficult.

Problems with the lighting system, you know, like,

maybe the lights wouldn't go off, which became a problem.

We didn't realise until night-time, when night fell,

and the patients wanted to get to sleep,

and we couldn't turn the lights off.

Erm, and problems with the plumbing,

and just, like, minor snagging things which,

in the big scheme of things, they're just minor snagging,

but if you're a patient, you know, lying in a bed,

wanting to go to sleep, or, you know, looking...

If you're a nurse searching for something that, you know...

The delivery system fell down in the first few day.

That was really difficult.

There's lots of change, you know -

the size of the ward, the single rooms, you know, erm...

Just making sure that we're still providing the same level of care.

During the day, the physios do have the patients up and about,

but it's just, if you look down the ward, you know,

you normally see lots of patients wandering around and...

At first, you know, it was a bit of a shock to us.

It didn't seem like a ward,

so we're trying to encourage the patients to get out and walk about.

MACHINE CHIMES We're doing the exact same job,

you know? Nothing's changed. it's still a surgical ward,

We've still got, you know...

You know, we're still pushed for beds.

We're still trying to get, you know, all our electives in.

We've still got the same pressures that we had previously.

Got my watch, got everything I need, I hope...

and go and get started.

Exciting.

Oh, I'm not used to modern stuff.

In spite of her hopes, Mel has been made nurse in charge.

I can't believe this! OK, that's fine.

Right, who's on night shift, cos I don't know who everyone is?

Who... As well as getting to grips with a new department,

she'll have to learn the names of new colleagues.

Would you mind doing resus with...?

Pauline, would you mind?

My wee friend, do you want to go with Pauline as well?

Where am I going? Resus.

Resus, all right.

So is three of them enough

there at the moment? For just now, yeah, absolutely.

Right, who wants to be second triage nurse?

I'm day shift.

I don't know who does triage. I'll do second triage. Is that OK?

Yeah. Right, and I'll try and remember everyone's names.

It just seems an awful lot of folk. Alannah...

And that's our first phone call coming for you. PHONE RINGS

Hello, Glasgow South, how can I help?

I think I'll start by having a look round the patients and seeing...

Do you know where everything is?

It'll take me a while to remember,

but if I have a look in each cubicle,

'and get the lay of the land with the spaces...'

Hi, there. Hi, I'm Mel.

I'm the nurse in charge tonight.

I'm just having a wee wander round to see...

'It looks like it's all going to work very similar.'

It's just on a much bigger scale and I'm a wee bit confused just now.

By the morning, in 12 more hours, I'll know what I'm doing, I hope.

So...

It's my very first shift in this hospital.

Well done.

We're on the case, OK?

OK. And we'll get you sorted out as soon as we can.

All right. And don't believe all you read in the papers...

Don't worry about that. OK.

Thanks very much. Bye-bye, now. Bye-bye.

Yeah, everybody seems to be really friendly, don't they?

So I'm hopeful. I think we'll be a good team.

I'm feeling very... optimistic, shall we say?

That's the doctor in to see you.

It may well be a brand-new hospital,

but the workload is all too familiar for consultant Kevin Thomson.

The police have just arrived with a homeless man who has self-harmed.

Mental health is part of the daily workload in A E.

'In the ideal world, we'd like to admit them to hospital.

'We'd like to give them a bed,

'We'd like to get all their social, sort of, problems sorted out,

'but realistically, that's just not achievable.'

And there is sometimes a bit of an educated gamble involved,

in the way that the... the life that

the emergency physician leads.

I can give him a psychiatric assessment,

and I don't think he's at risk.

'My take was that he wasn't suicidal.

'He was looking for somewhere to stay tonight,'

so sometimes you just have to patch them up

and send them out.

Well, if she's got a headache with that,

then she gets admitted. OK, fine.

For Kevin, the new admissions system is beginning to have an impact.

The big thing that we are being involved in is

that we are starting to see purely emergency patients again.

We have lost the necessity to see and treat the GP referrals,

and that takes a large workload off our department.

'It takes a large work load off the...

'particularly the nursing staff.'

So I think, for the first time in a long time,

we are an emergency department, 100%, which is good.

It's good for everybody.

'We don't seem to be having a problem in Accident and Emergency

'with timing.'

That's not been too bad here.

I think the problems will be further along in the ward,

when we're running short of beds,

so I don't quite know what's going to happen then,

if then people will back up here,

but we'll wait and see.

Hopefully not.

A E may be beginning to function well

but for waiting times to improve... Hello, Emergency Department.

..there has to be space for patients to be admitted to the wards upstairs.

There's going to be teething problems.

The department's going to evolve,

and certainly evolve more as the third department joins us.

The patients are still going to come through that door.

They're never going to stop doing that.

We are always going to be able to see them

but we need that door to be open at all times.

We need beds to be available.

That's going to be the big problem in this hospital.

Next time - Yorkhill Children's Hospital is on the move.

Are you going to the new hospital?

Right, say bye!

Blow kisses.

And although some departments in the new hospital

have settled in well,

as the last adult hospital moves in,

the shortage of beds makes waiting times in the new A E

the worst in Scotland.