Patient Safety Commissioner for Scotland Bill

1. Audit Scotland welcomes the opportunity to respond to this call for views. Audit Scotland is a statutory body established under the Public Finance and Accountability (Scotland) Act 2000. It is Scotland’s national public sector audit agency which provides the Auditor General for Scotland and the Accounts Commission with the services they need to carry out their duties.

2. We welcome the establishment of a role that focuses on ensuring the patients’ voice is heard and listened to. We should not underestimate how important it is that the patients’ experience is seen as an important aspect of quality in the delivery of health care. The failure to effectively listen to the views and experiences of patients has in the past led to opportunities being missed to deliver improvements, as seen by several public inquiries and independent reviews, such as in Mid- Staffordshire and the Ockenden Review.

3. The specific suggestion in the Cumberlage Review was for a commissioner to: “champion the value of listening to patients and promoting users’ perspectives in seeking improvements to patient safety around the use of medicines and medical devices”. The Patient Safety Commissioner in England’s core role is to: ‘promote the safety of patients in the context of the use of medicines and medical devices and to promote the importance of the views of patients and other members of the public in relation to the safety of medicines and medical devices.’

4. The role and responsibilities of the Patient Safety Commissioner for Scotland appear to be much broader. But their overall remit could be much clearer. The definition of what we mean by ‘patient safety’ or ‘safety issues’ needs more clarity, it could involve a huge range of different issues like patient experience and staffing levels.

5. In this context, the Patient Safety Commissioner will operate in an already complex landscape and the boundaries with and between different organisations across the health regulation, inspection and scrutiny landscape could also be clearer. There are many potential overlaps and possible areas of duplication. Further detail and clarity around the remit and boundaries would be welcome.

6. There is also a risk that an already complex landscape will become more complex for the public, in truly understanding where to take their concerns and what they can expect from that route. Further clarity around the remit and boundaries would also help try to mitigate this risk.

7. It is difficult to predict the extent of issues and areas that will come to the Commissioners attention, but their remit is broad so we could anticipate them having a significant workload and the proposed funding and resources are modest. There is a real risk that the funding and resources will not be sufficient for the Commissioner to carry out the role and responsibilities as currently set out.