Today I am pleased to publish the first Annual Report of the Patient Safety Commissioner for Scotland. It marks the conclusion of our first year as a newly established parliamentary office and provides an opportunity to reflect on what we have heard, what we have learned and where our work will focus next.
When the Scottish Parliament created this role, it did so with an important purpose: to ensure that the experiences and concerns of patients, families and carers help drive improvements in the safety of healthcare across Scotland. Independence is central to that purpose. The Commissioner is accountable to Parliament and exists to provide a distinct perspective, informed by patient experience and focused on learning, improvement and assurance.
Throughout our first year, we have invested significant effort in establishing the foundations of the Office. We recruited our first staff members, established governance arrangements, created a statutory Advisory Group, developed our Investigation Framework and began building relationships with organisations across Scotland's healthcare system.
Most importantly, we listened.
Over the past year, patients, families, carers, healthcare professionals and members of the public shared 228 concerns, experiences and enquiries with the Office. While the details differed, common themes emerged. People told us about communication challenges, difficulties accessing care, concerns about rural healthcare provision, fragmentation between services, safeguarding issues and the need for greater transparency when things go wrong.
Those conversations have directly informed the six national priority areas identified in this report:
Maternity and neonatal safety
Displaced care and Hospital at Home
Single-sex hospital wards
Acute mental health care
Rural and island healthcare inequalities
NHS board restructuring
The report also highlights a wider observation that has shaped much of our thinking during this first year. Scotland's healthcare system is rich in improvement activity, innovation and commitment. However, there are occasions when patients, families and staff seek assurance that improvements are being sustained and that concerns are receiving independent scrutiny. This challenge is captured in a phrase used throughout the report:
"Scotland's healthcare system is improvement-rich but assurance-light."
This is not a criticism of those working within the health service. Throughout our visits to NHS boards across Scotland, we met dedicated professionals working under considerable pressure while striving to deliver the best possible care. Rather, it is a recognition that confidence is strengthened when improvement is accompanied by robust assurance and transparent learning.
As we move into our second year, we will continue to develop the Office's work through the implementation of our Investigation Framework, publication of our Strategic Plan, development of the Patient Engagement Framework and continued engagement with patients, families and healthcare partners throughout Scotland.
Above all, we will continue to ensure that patient voice remains at the centre of everything we do.
I would like to thank everyone who has contributed to this first year, particularly those who took the time to share their experiences with the Office. Your willingness to speak up, often during difficult circumstances, is helping shape safer healthcare for others.
The Annual Report 2025-26 can be read in full here: Reporting | Patient Safety Commissioner Scotland
Karen Titchener
Patient Safety Commissioner for Scotland
