Patient Safety Commissioner role for Scotland: consultation

This paper seeks views on what the Patient Safety Commissioner role should look like; who it should report to; and how the role should interact with existing legislation and policies, as well as with the various organisations involved in providing and improving health and care services in Scotland.

Chapter 5: Powers of the Patient Safety Commissioner

A key point, raised by both Baroness Cumberlege and the Patient Reference Group, is the need for the Patient Safety Commissioner to have statutory powers. This means the role would need to be created in law, which is likely to take some time due to the Parliamentary process that is necessary to bring it about. We may be able to set up the role without legislation, for example by making it part of an existing organisation such as Healthcare Improvement Scotland.  The commissioner could still carry out their role and build on existing relationships and processes, rather than creating an entirely new operation.  This would mean that we could set the role up more quickly and the commissioner could begin work sooner.  However, depending on the organisation that the role is within, it may not be entirely independent of the Scottish Government or the NHS.  Or, we may be able to set the Patient Safety Commissioner up as a company without going through the legal process.  

Establishing the role in law would allow the Scottish Parliament to grant powers to the Patient Safety Commissioner and to place duties on some bodies to work with them. However, even if the role is established in law, the commissioner's powers would be limited.  For instance, as regulating medicines and medical devices is a reserved issue (that is, legislation on these matters can only be introduced or changed by the Westminster Government), any Scottish legislation could not, for example, competently place duties on the Medicines and Healthcare products Regulatory Agency (MHRA) to meet the recommendations of the Scottish Patient Safety Commissioner.  However, the Scottish Patient Safety Commissioner could possibly be given a role to try to work with regulatory bodies such as the MHRA to improve patient safety.

We need to consider what powers the Patient Safety Commissioner will have and the challenges that these powers bring to the role.  A lot of the Patient Reference Group's discussion focused on the lack of trust in the NHS and the Government, and on people feeling let down.

A major challenge for the Patient Safety Commissioner will be to work with others to continue to create a safe space for those working in the health service to admit faults or mistakes without fearing repercussions, so that they and others can learn from these mistakes.  Achieving this culture of openness and learning is one of the key principles of the organisational Duty of Candour legislation, and continues to be a focus for organisations such as HIS, through programmes of work such as the Improvement Hub (iHub), which incorporates the Scottish Patient Safety Programme (SPSP), and Health Boards' reporting adverse events using the HIS Adverse Event Framework (see [5] below).

Question 11: Do you think that the Patient Safety Commissioner role should be established in law?



Don't know

Please give reasons for your response in the box below. Please be as specific as you can, and include any resources or references to evidence on this topic that we should consider.



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