Patient Safety Commissioner: consultation analysis

Consultation on a Patient Safety Commissioner Role for Scotland: Analysis of Responses - Summary

Scottish Ministers committed, in Protecting Scotland, Renewing Scotland: The Government's Programme for Scotland 2020-2021, to establishing the role of a Patient Safety Commissioner. The Consultation on the Establishment of a Patient Safety Commissioner Role for Scotland sought the views of the public and other interested parties on what that role should look like; who the Patient Safety Commissioner (PSC) should report to; and how the role should function.

This report provides an analysis of responses to the Scottish Government's consultation on a PSC role for Scotland, which ran from 5 March 2021 to 28 May 2021.

96 responses were received of which 46 responses were from organisations and 50 responses were from individuals. A total of 88 responses were published on the Scottish Government website and all responses are included in the analysis.

Below is a summary of the main responses and themes.

Should the initial focus of the Patient Safety Commissioner be on medicines and medical devices? And in the future?

• Most respondents agreed that the Patient Safety Commissioner role should initially focus only on medicines and medical devices, as recommended in the Cumberlege review. However, it is clear that there is support for the role expanding at some point.
• When the role does expand, it was suggested that the PSC should cover communication; policies, processes and systems such as adverse event reviews; learning; and accountability.
• Specific topics were also mentioned, such as ensuring the safety of healthcare products, or specific conditions such as mesh.
• Other suggestions were that the PSC should focus on patient safety in general terms or that the PSC once established should determine their own priorities.

Independence and accountability

• There was strong support for the role being independent of both the Scottish Government and the NHS, and accountable to the Scottish Parliament.

Existing processes and policies

• A list had been provided within the consultation document setting out some of the policies, processes and pieces of legislation that are already in place to support the patient voice within the healthcare system. The narrative highlighted the fact that it will be important that the PSC does not duplicate what already exists.

There is a varying level of awareness of existing processes and respondents also highlighted the challenges of engaging with these, including: inaccessibility and complexity and/or time consuming nature of many of the processes.

• Lack of awareness or promotion of options for feeding back/complaining.
• Trust issues - patients being dismissed or not believed and a lack of trust or confidence in current systems and processes as not independent.
• Concern about reprisals/anonymity.
• Systems and/or processes seen as tokenistic with no action taken, or patients not given feedback on actions that are taken.
• Agencies not being joined up, so patients have to give the same feedback to numerous agencies.

Main functions and skills of and support for the PSC?

• In terms of functions, the PSC should provide a clear route for patients to express concerns and should listen to and act upon the patients' voice as well as ensuring learning and change happens as an outcome of patients raising concerns. Investigating or intervening in the care and treatment of patients (including holding organisations to account, scrutiny, reporting and monitoring) was also seen as important. There was also an emphasis on the PSC acting quickly as some of the existing processes are seen as taking a long time.
• Some of the skills highlighted were compassion, caring, empathy, lived experience, political acumen; knowledge of the NHS, self-confidence, ability to lead.
• In terms of support, responses highlighted the need for an office system to support the role as well as different kinds of expertise, including analytical, communications, IT, professional, clinical, legal, safety, ethics, equalities and human rights experts.
• Alongside these the PSC will need support and input from other organisations and individuals, particularly patients, as well as sufficient financial resources to ensure that they are able to carry out their role.

Should the PSC role be established in legislation?

• There was strong support for the role being set out in legislation. Reasons given included: to ensure that the PSC has the necessary powers; to protect the role and ensure independence; to provide assurance to patients; and because this is what was recommended in the Cumberlege Review.