Patient Safety Commissioner for Scotland Bill Advisory Group minutes: June 2022

Attendees and apologies

• Donna O’Boyle (Co-chair)
• Charlie Bethune (Patient Co-chair)
• Rosemary Agnew
• Alison Britton
• Julie Campbell
• Lynsey Cleland
• Susan Cole
• Innes Connor
• Nicola Cotter
• Claire Goodheir Curtis
• Rona Johnson
• Emma Mackay
• Lisa Megginson
• Sharon Mercado
• Jennifer Stewart
• Simon Watson
• Craig White
• Bill Wright
• Graeme Aitken
• Jenny Hunt
• Will Wood
• Dominic Ellice-Freeman (observer)

Apologies

• Pauline Bennett
• Claire Daisley
• Gordon Johnston
• Aileen Lawrie
• Marie Lyon

Items and actions

Agenda

• welcome and introductions
• terms of reference
• Patient Safety Commissioner background including update on work so far 
• impact assessments
• breakout sessions on impact assessments
• feedback from breakout sessions
• next steps
• any other business (AOB)

Welcome and introductions

Donn O'Boyle welcomed attendees to the meeting and noted apologies. She introduced Charile Bethune in his role as Patient Co-Chair for the group. 

Terms of reference 

Members were asked to agree to the Terms of Reference. It was agreed that minutes would be published but would not be verbatim, and would not attribute comments directly to individual members.  

The group agreed to the Terms of Reference.

Update on work to date

Jenny Hunt gave a brief presentation explaining the Scottish Government’s work towards establishing the Patient Safety Commissioner to date. She noted that the Scottish Government expect to be able to introduce legislation to parliament in the autumn, although this was subject to final ministerial approval. 

Members commented on the importance to victims and survivors of seeing progress on creating the Patient Safety Commissioner and implementing the other recommendations of the Cumberlege Review (which were out of scope of this group’s work). 

Impact assessments

Jenny Hunt briefly spoke about the purpose of the impact assessments. A paper explaining this in greater detail had also been shared with the group in advance of the meeting.

Breakout sessions on impact assessments

Group 1: the Equalities Impact Assessment and Fairer Scotland Duty

This group considered the following questions:

• what risks would a Patient Safety Commissioner need to be aware of when engaging with people with protected characteristics, or those who are socio-economically disadvantaged? 
• what would an ideal Patient Safety Commissioner do so that these groups have equal access to their services and help? 

The following themes emerged from the discussion:

• that ‘patient safety’ means different things to different people. The Commissioner must not take a ‘one size fits all’ approach
• the Commissioner should use digital ways of working and engagement, but should also put arrangements in place to ensure they are accessible to people who do not have digital access or prefer non-digital means of communication
• the Commissioner should be supported by sufficient resource, skills and powers to enable them to organisations to account
• the Commissioner should be comfortable with complexity. The patient safety landscape, and the wider context within which the Commissioner will operate, are complex
• the Commissioner should be proactive, approaching groups and individuals for their input rather than waiting for people to come to them. This is especially important for people with protected characteristics or who suffer socio-economic disadvantage
• the Commissioner should work in a way that is transparent
• some members commented that the Commissioner should not signpost patients to other places, as this is tiring for patients. Others suggested that while the Commissioner will inevitably have to signpost patients to other organisations at times, this should be followed up to ensure those organisations are providing a good service

Group 2: the Health Inequalities Impact Assessment

This group considered the following question:

• what particular considerations would a Patient Safety Commissioner have to be aware of relating to people living in different population groups who are vulnerable to unfair differences in health outcomes, such as those living in lower socio-economic groups or people living in remote or rural locations?

The following themes emerged from the discussion:

• the Commissioner should be proactive in seeking out patient safety issues and working with others to rectify them. This is an important opportunity to identify health inequalities and address them
• the Commissioner should keep up to date with current trends and population changes in Scotland and develop an understanding of the needs of different population groups
• the Commissioner’s focus must be on preventing future harm, informed by what has happened in the past
• the patient safety landscape is complex and therefore the Commissioner must develop an understanding of who the key players are
• the Commissioner must be accessible to people in rural and island communities. Travel to Edinburgh and Glasgow can be a barrier to patients living elsewhere in Scotland
• the Commissioner should proactively engage with patient groups who are isolated, for example people in care homes
• the Commissioner should raise awareness of patients’ rights as part of their role. Many patients do not know what their rights are
• the Commissioner should be able to access medical records to help patients uncover the truth about harmful treatments they may have been exposed to

Feedback from breakout sessions 

Both groups shared findings from their sessions. It was agreed that summaries of the sessions should be included in the minutes [as above].

There was a brief discussion about how the Patient Safety Commissioner could help people with rare conditions but who do not have protected characteristics. Scottish Government attendees agreed to follow this up separately.  

Closing  

Donna O’Boyle thanked attendees. The group agreed that at least one further meeting would be held before October 2022.

Papers

• terms of reference
• equalities discussion paper