Chamber and committees

People have also intimated that the patient safety commissioner’s role should be about healthcare, not health and social care. However, if we move towards having a national care service, which would encompass the whole of a patient’s care journey, would you expect the remit to be wider and to include social care down the line?

Good morning, everybody. I have a quick question about the remit of the patient safety commissioner. Sometimes the impact of care or—I should say—unsafe care is not directly or overtly evident. I note that Dr Williams suggested that the commissioner’s remit should include advocating for patients. I am thinking of groups or populations in which harm has occurred as a result of, say, a lack of compassion or some other issue that is not directly related to safety. Would you expect the patient safety commissioner’s remit to be wide enough to cover the patient population to whom overt harm might not have been caused?

It is for Dr Williams.

Dr Lamont, I want to pick up on what you said about amplifying the patient’s voice and about avoiding harm in the first place and addressing concerns. I will use an example that I used last week. People in the south-west of Scotland get radiotherapy in Edinburgh, which means that on their way they pass within 4 miles of the Beatson cancer care centre. I think that it is a 240-mile round trip. People’s voices in the south-west of Scotland are not being heard when it comes to cancer pathways, for instance. Harm has not necessarily occurred, but the simple fact of being those miles away from their family, Monday to Friday, might lead someone to drop out of radiotherapy. They might say, “I’m fed up. I’m no doing it any more.” Is that something that the patient safety commissioner could consider? They could go to NHS National Services Scotland or Healthcare Improvement Scotland—whichever pathway it is—to help to sort it out.

I am also thinking about what you said earlier. In my notes, I have written “listen, advocate, champion”. I am thinking about risk assessment and risk management, and about being heard. I do not know if that has been missing in the past. That might have been Fraser Morton’s experience.

One of the first things that the website of Healthcare Improvement Scotland says is that

“the affected person receives the same high quality response”

and that

“organisations are open, honest and supportive towards the affected person, apologising for any harm that occurred”.

That information was an update about adverse events that had happened previously. I am interested to hear about your experience of interacting with the current systems of scrutiny and clinical governance. Where are the gaps and weaknesses in the current systems? How will the patient safety commissioner help to fill those gaps? Perhaps Fraser Morton would like to come in on that.

Good morning, everybody. Thank you for coming. What are your thoughts on whether the patient safety commissioner for Scotland should have a wider remit than that of the commissioner in England, for example? That would go wider than mesh, sodium valproate and Primodos.

I will pick up on some of the questions about the patient safety commissioner’s remit. Baroness Cumberlege’s report wanted the commissioner to look at medicines and medical devices, which is what the commissioner in England is doing, but the remit here seems to be broader. Thinking about all the people who are involved in promoting safe patient care, there is a bit of a crossover that I am worried about. I am interested in how the panel feels about widening the remit to enable the patient safety commissioner to hear from people who have had poor experiences.

My question might be more relevant for the next panel of witnesses. I am thinking about the system for reporting incidents, which is perceived as punitive by healthcare staff. It is better to deal with near misses than to wait for a significant adverse event. My background is 30 years of operating room nursing. It is highly technical. It is very unsafe—not in the sense of the practice, but there are sometimes so many barriers, and it is a team-driven environment. Errors are not intended, but the Swiss cheese model comes to mind when we talk about patient safety.

I am interested in hearing your thoughts about how we need to encourage the reporting of incidents so that we can put effective measures in place to prevent them and about how that would support a patient safety commissioner’s work to look at encouraging reporting so that we can develop safer methods.

Thanks for letting me back in, convener.

The National Rural Health Commissioner in Australia listens to people and advocates for them so that their voices are heard. A new report has made it pretty clear that some people have been campaigning for decades. What are your thoughts on how firm the role of advocacy and listening to people needs to be in a patient safety commissioner?

Good morning. I am interested in the remit of the patient safety commissioner for Scotland, and in comparing it with the English commissioner’s remit. We have lots of commissioners in Scotland. According to my notes we have, for example, an equalities and older persons commissioner, a veterans commissioner and the Children and Young People’s Commissioner Scotland. I am interested in how the proposed role would work with all the other commissioners and how it would be different.