Patient Safety Commissioner: consultation analysis

Chapter 4: Responses on independence of the Patient Safety Commissioner

There were 3 questions in the consultation document which related to the independence and accountability of the PSC role in Scotland.

Question 3: Do you believe that the Patient Safety Commissioner should be independent of the Scottish Government?

A significant majority of those who responded to this question (83%) believed that the PSC should be independent of the Scottish Government, with some saying it was 'absolutely essential'. Reasons given for this view included concerns about conflict of interest and political interference and to ensure transparency and impartiality. The organisations that responded and answered yes to this question again were a mixture of NHS bodies and other organisations. The few respondents that were not of this view generally thought that the PSC and Scottish Government would need to have some relationship to each other.

Some respondents answered 'don't know' to question 3, citing uncertainty about the pros and cons of what 'independent' actually means. One respondent suggested that the role should sit within the Scottish Government but with a representative in every NHS Board.

Other respondents did not choose a particular option, but provided comments nonetheless, such as the need for the PSC to be accountable to someone, whether Scottish Government or not, and also whether it would even be possible for the role to be completely independent of Scottish Government.

Question 4: Do you believe that the Patient Safety Commissioner should be independent of the NHS?

Again a significant majority of those who responded to this question (86%) believed that the PSC should be independent of the NHS. Those individuals who responded offered views such as that the PSC would thereby bring a fresh perspective to issues or that the PSC by definition would be investigating the NHS, so needed to be independent. Others highlighted the fact that their personal experiences did not lead them to trust the NHS, and impartiality and objectivity were recurring themes in the responses.

Again, organisations who responded yes were a mixture of support organisations and NHS bodies. As with individual respondents, impartiality, objectivity and trust were key themes.

'It is important to ensure that the work of the Commissioner is led by patients and their experiences.'

One organisation made the point that the issues under consideration will also cover independent healthcare providers, so will not be restricted to the NHS.

The small number who responded no were a mixture of NHS bodies and individuals and were of the view that the work of the PSC would need to link up with the NHS in some way and would need to have experience and understanding of the issues.

Question 5: Who should the Patient Safety Commissioner be accountable to?

82 respondents answered this question (35 organisations and 47 individuals). This was an open question inviting free text responses. The organisations who responded offered a mix of views, but the majority thought that the PSC should be accountable to the Scottish Parliament, citing the example of other Commissioners such as the Commissioner for Children and Young People or the Prisons Inspectorate. Some felt that it could usefully be aligned to the Scottish Public Services Ombudsman (SPSO) and several made the point that the internal governance of the organisation should include patients.

As with organisational responses, some of those individuals who responded suggested also highlighted accountability to the Scottish Parliament. However those responding as individuals offered a wide variety of views including an independent Board or elected body; patients and the people of Scotland; the Chief Medical Officer; or the Scottish Government.