Intended for healthcare professionals


Scotland to create patient champion role

BMJ 2020; 370 doi: (Published 03 September 2020) Cite this as: BMJ 2020;370:m3469

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Cumberlege review exposes stubborn and dangerous flaws in healthcare

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Scotland to create patient champion role

  1. Bryan Christie
  1. Edinburgh

A patient safety commissioner is to be appointed in Scotland to champion the views of people who have been harmed by treatments provided by the health service.

It is one of the central recommendations following a review led by life the peer Julia Cumberlege into three treatments—Primodos, sodium valproate, and pelvic mesh—that resulted in birth defects, learning difficulties, and life changing complications for thousands of women.1 Although the review’s recommendations were directed at the healthcare system in England, Scotland has decided to act on creating a patient safety commissioner role.

The Westminster government has yet to respond to the review’s recommendations and came under further pressure this week when a debate in the House of Lords led to peers calling on the government to implement them in full.

In a letter to the health and social care secretary for England, Matt Hancock, that accompanied the findings of the review, Cumberlege said that the NHS was not good at spotting trends that gave rise to safety concerns. “Listening to patients is pivotal to that. This is why one of our principal recommendations is the appointment of an independent patient safety commissioner. The commissioner would be the patients’ port of call, listener and advocate, who holds the system to account, monitors trends, encourages and requires the system to act,” she wrote.2

In its programme of government for the coming year the Scottish government said that it was considering the full recommendations of the Cumberlege review but that it was committed to creating the role of a national advocate for patients. No further details were given. Earlier this month the Scottish health secretary, Jeane Freeman, said, “What that role looks like, where it would sit, and how it would function needs to take into consideration the Scottish context and landscape, so would require further work, including consultation with patients.”3

Not all health service leaders are convinced there is a need for such a role. The chief executive of the Care Quality Commission, Ian Trenholm, has questioned the value it would bring. In an interview with the Health Service Journal he said, “If you look at the work we’re doing on patient safety, the work that HSIB [Healthcare Safety Investigation Branch] are doing on patient safety, and then we’ve got people within the NHS itself doing work on patient safety, I think there are enough people playing. The question is, are we all working together as effectively as we possibly could be? If another player helps that work [then] great, but I’m not sure that’s something that is necessary.”4