Commenting after the publication of the review into NHS Ayrshire and Arran’s management of adverse events, following the death of twenty patients and its FOI failings, Scottish Liberal Democrats Health spokesperson Alison McInnes MSP said:
“It is important that NHS Scotland has a consistent approach to protect patients from harm and I welcome the national framework established by the Health Secretary.
“It is, however, important to remember that these serious failings occurred within NHS Ayrshire and Arran due to a fundamental breakdown of communication within that health board. National strategies only form part of the solution to a problem that saw a failure to learn lessons from adverse incidents, including the death of twenty patients.
“This review identifies confusion, lack of accountability and uncertainty surrounding action plans when failings were discovered. It is shocking that the chain of command allowed clinical governance to disintegrate to this level before action was forced upon them under tragic circumstances.
“It is vital that these recommendations are implemented in full as a matter of urgency. No matter how painful or embarrassing it may be, the lessons must be learned to safeguard patients.”