Meeting of the Parliament 02 March 2017
Twenty years ago, I was involved in the improvement of safety in the perioperative environment in the United States as part of a collaborative approach with the USA’s Institute for Healthcare Improvement. For example, I taught best practice and a standardised approach for surgical counts of swabs, needles and instruments, in order to avoid the retention or loss of a surgical instrument inside an abdomen. There is growing implementation of non-technical skills to safeguard patients. That approach has been adopted and promoted in the USA as well as here in Scotland. Those skills relate to things such as situation awareness, good decision making, a flattened hierarchy, leadership and a good approach to teamwork and communication. In Scotland, research on that has been procured and continued by Dr Steven Yule and others at the industrial psychology research centre in Aberdeen.
When I was a clinical educator for NHS Dumfries and Galloway, the training programmes that my colleagues and I initiated for healthcare support workers and nurses had a specific focus on safe, effective and person-centred care. I collaborated with colleagues regarding verbal handover from the anaesthetist to the post-anaesthesia recovery room nurses so that clear plans of care were identified and documented. I also provided education about deep venous thrombosis prophylaxis and prevention, central venous access line infection and medication safety, so that the right patient, drug, dose route and time were achieved, which improves the safety of patients.
Quick, snappy education sessions, for example on the sepsis six, were delivered using the one-minute education approach. I could continue to give examples of these seemingly small but immensely important measures that can make the difference between life and death. They are vital to the improvement of both acute and primary patient care.
I am pleased to be able to speak in the debate, not least because it enables me to say to Parliament that my former colleagues in NHS Dumfries and Galloway and across NHS Scotland deserve to be commended for and congratulated on their on-going work to promote best practice using evidence-based care. Too often, we hear nothing but negativity surrounding our NHS, and I can tell members that that has a real effect on the morale of the nurses and doctors.
I was proud when, in 2008, Scotland became the first country in the world to launch a national patient safety programme. The programme has been vital to delivering the highest-quality healthcare services to the people of Scotland and is recognised as world leading in the quality of healthcare that it provides. In fact, when he was President, Barack Obama mentioned Scotland as having one of the best healthcare systems in the world.
Since its launch, the acute adult programme has contributed to a significant reduction in harm to and mortality in adult patients through measures such as those that I have described, and many more. Since 2008, the scale and ambition of the programme has grown and the work, which began in acute adult hospitals, now extends to primary care, mental health and maternal and child health.
There are many examples of cultural change that has been brought about by the programme, notably in mental health settings, where we have seen a real shift in the approach that is taken to the administration of psychotropic medication and improvements in how challenging behaviour is managed.
The Scottish patient safety programme will continually adapt to meet our changing needs and will embrace new technologies and approaches to care. We should be proud that, thanks to its implementation, Scotland plays a leading role in patient safety initiatives in Europe. NHS England officials have praised the programme, stating that they hope to use the experiences and learning to take forward practices in England. According to Dr Marc Wittenberg, a clinical fellow at NHS England, the programme is “unrivalled” and contains much that should be replicated in England.
The 8.6 per cent reduction in hospital standardised mortality and the praise from bodies such as the Organisation for Economic Co-operation and Development and NHS England show exactly why the Scottish patient safety programme deserves its international reputation as a world leader.
15:53