Openness and Learning: Joint Statement

Following the commentary surrounding the High Court of England and Wales judgment on the case of Dr Hadiza Bawa-Garba, we want to restate the need for all staff to be able to reflect safely and openly when things go wrong. We recognise the distressing and long lasting impact that cases such as this have on patients, families and staff.

Safety is at the heart of everything we do in NHSScotland and vital to building a culture which allows all frontline professionals time and safe spaces to learn in order to improve services in a culture of openness and without fear of censure. The Scottish Government's commitment to this is strongly demonstrated in the development of our approach to openness and learning.

The organisational duty of candour legislation, which we intend to come into force in Scotland on 1 April 2018, includes a legal requirement for organisations to provide details of services to support employees involved in unintended or unexpected incidents. It also requires organisations to involve those who have been harmed and, where appropriate, their families, in meetings and reviews of incidents. These new statutory provisions were informed by policies of supporting all those affected by harm events - staff, patients and relatives - to work with organisations on reviewing them to identify the organisational learning and improvements necessary.

We are also clear that it is essential to foster a culture within our NHS where staff can raise any concerns they may have about patient safety and malpractice because it helps to improve our health service.

To support this in recent years we have introduced a single national whistleblowing policy, an independent whistleblowing alert and advice line and are establishing an Independent National Whistleblowing Office (INWO) by the end of the year which will be a further step in developing an open and transparent reporting culture in our NHS.

In addition, the Scottish Patient Safety Programme (SPSP) is a unique national programme which very deliberately uses a collaborative approach which supports local teams within hospitals, GP practices, mental health inpatients units and community pharmacies to reduce harm and improve the safety and reliability of healthcare wherever it is delivered. Local teams are enabled to explore and understand how harm can occur and test and implement improvements using improvement methodology.

In this, the 10th year of the SPSP and in the lead up to the introduction of the duty of candour, we want to restate our commitment to supporting all staff across NHSScotland to be able to examine and understand when things go wrong in a supportive learning culture.

Professor Jason Leitch
National Clinical Director, Healthcare Quality and Improvement, Scottish Government

Catherine Calderwood
Chief Medical Officer for Scotland

Professor Fiona McQueen
Chief Nursing Officer for Scotland