A letter sent by Dr Peter Scott-Gordon to Dr Lade Smith, CBE, President of the Royal College of Psychiatrists:
4th February 2026
Dear Dr Lade Smith,
PATIENT SAFETY
I wanted to write to you to say thank you for engaging with me as President of the Royal College of Psychiatrists in relation to a number of matters. I particularly wanted to thank you for your kindness and professionalism in this. I am aware that your period as president is coming to an end (how time passes!) and that a democratic process is underway to find the next College president.
You will doubtless be aware of a number of current inquiries, right across the UK, into serious matters relating to patient safety. In one recent example, Fred Mackintosh, KC, Senior Counsel to the Scottish Hospital Inquiry, said to BBC Scotland on 23rd January 2026:
“Senior leaders effectively need to know that if they show wilful blindness or complacency or don’t ask questions when patient safety issues arise, in due course they will be held to account”.
Given this context it is important that the College does not ignore patient safety issues, including in its forthcoming election process which is likely to face wider public scrutiny than ever before.
I hope that the election process, including the hustings, will include consideration of patient safety issues. I appreciate that this may be challenging for the College as it is primarily a membership organisation and supporting the interests of its members is understandably its priority. However, there is a very real risk that a defensive approach interferes with, or indeed impedes, College acknowledgment of, and support for, patients harmed by psychiatric treatments. Given the recent warning issued by Fred Mackintosh, KC, the College has to be aware that its long-term reputation could be at risk. Psychiatry, like all branches of medicine, is dependent on the trust that patients have in it.
It is disappointing that the College has made no official response to the First Do No Harm Cumberlege recommendations which were published in the summer of 2020. This is a missed opportunity to accept accountability and demonstrate a willingness to learn. This apparent defensiveness by the College may be one of the reasons why over 1 million people in the UK are seeking support from Facebook and other social media groups in relation to prescribed psychiatric drugs.
The risks and benefits of social media use are issues affecting all of society and continue to be widely debated. In this environment it is more important than ever that the online behaviour of College members adheres to the highest possible professional standards. The College needs to remember that social media contributions, both past and present, of its office bearers are open to scrutiny.
Thank you again for taking the time to listen to my concerns and I wish you all the best for the future. I do hope that the College can demonstrate genuine engagement with patient safety issues and that these can be openly discussed in the election process for the next office bearers of the College.
Yours sincerely,
Dr Peter Scott-Gordon
Copied to:
[1] Sonia Walter, CEO of RCPsych
[2] Wes Streeting, Secretary of State for Health and Social Care
[3] Patient Safety Commission/Commissioners
[4] Marion Scott, The Sunday Post
Reply from Dr Lade Smith, CBE, President of the Royal College of Psychiatrists:
An html version of above which includes the links in the letter sent by Dr Lade Smith:
6th February 2026
Dear Peter,
I hope this finds you well.
Patient safety and the quality of care provided to people is a paramount concern for the College. Everything we do, including supporting psychiatrists in their work, is aimed at improving outcomes for people with mental illness.
As you know, mental health services have been underfunded for many years and suffer from chronic understaffing. This affects access to care, as well as the ability of staff to provide excellent quality care for all their patients. This is something the RCPsych advocates about constantly.
With respect to individual practitioners, we expect that all will do their utmost to provide the best quality care that is safe. We provide guidance, education and training to support them to do this.
Regarding the Cumberledge report (First Do No Harm – Independent Medicines and Medical Devices Safety Review: update report on government implementation, 2020), the College updated our Sodium Valproate Position Statement in light of the recommendations and reviewed and updated this again last year.
The Cumberledge report looked at 3 medical interventions that were not specific to mental health, nonetheless, we contributed to and signed up to a statement put out by the Academy of Medical Royal Colleges, of which we are a significant member. The statement was released on behalf of all Medical Royal Colleges and can be found here. In addition, we were part of the development of the 2021 Guidance document on the use of sodium valproate for women and girls (here).
I hope this helps to reassure you that we take patient safety very seriously. The hustings will focus on questions from the membership. There are always questions about patient care and the quality of mental health services, because this is what our members care about.
With all good wishes,
Lade
Dr Lade Smith, CBE
President of the Royal College of Psychiatrists
Below is the full statement by the Academy of Medical Royal Colleges that Dr Lade Smith mentions in her letter to me. I am not aware that there has been any update to this initial statement, particularly in relation to the final paragraph: “We will work with colleges and other stakeholders to ensure that agreed recommendations are implemented as quickly and effectively as possible.” I would have expected a follow-up statement but have been unable to find any.
