How we came to make patient safety paramount - Simon Watson

In the space of 20 years, the idea of patient safety has gone from something that few clinicians comfortably talked about to something that we are now doing on a grand scale. The Scottish Patient Safety Programme broke the mould, demonstrating how a whole country could not only agree on key healthcare priorities, but work together in a co-ordinated way to learn from them.

I have vivid memories of having really difficult conversations around patient safety in the past where the topic was met with a lot of defensiveness, hostility and a sense that somehow you were accusing others of being incompetent. The first change was cultural - to actually talk openly about patient safety, gaining confidence that there were things to learn from other sectors. The second change was doing this on a nationwide scale, which Scotland did through a range of initiatives within, or linked to the Scottish Patient Safety Programme. Now we’re addressing patient safety within hospitals, GP practices, hospices and other social care settings, like the safety of healthcare in prisons, in a way that was hard to imagine 20 years ago.

What are the challenges

When we look at the current challenges, we need to come up with solutions that are achievable and that people have confidence in.

Simon Watson, Medical Director at Healthcare Improvement Scotland

We know that people who haven’t been treated as soon or as well as we’d have wanted them to be, because of the pandemic, are now sicker, needing more care with fewer resources in the system to deal with them, creating an environment for a perfect storm.

To have a safe system, we need financial stability, a good workforce, stable leadership and clear processes without excessive demand. Right now, these things are being challenged nationally coming off the back of the pandemic and exacerbated by the economic disruption we are experiencing.

Focused on the way ahead

There were some major threats to the health of the population before the pandemic, which unfortunately have only continued to grow. For example, antimicrobial resistance is one of the biggest threats to humanity and Healthcare Improvement Scotland has a very specific role to play in this vital area. Similarly, waiting times across a variety of settings within the NHS continue to increase and while we are faced with the immediate issue of the winter crisis, we also have other challenges further down the line. We’re sailing into a headwind with a system that is running hard just to try and keep up. We must use intelligence to understand where the highest risks are and what our most important priorities should be.

The focus must to be on collaboration and problem solving. Patient safety will only improve in these challenging times if these areas are everyone’s focus. I believe our organisation – our knowledge, experience and skills – can play a vital role to help patients and the NHS keep care as safe as possible. In the same way as we have in the past, we’re ready to be a force for improved patient safety now and in the future.

Simon Watson, Medical Director at Healthcare Improvement Scotland