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Measures to Improve Patient Safety

The UK Government has published details of plans to improve patient safety in England through the introduction of a new investigative body - the Health Service Safety Investigations Body (HSSIB). 

New Investigative Powers

The draft Health Service Safety Investigations Bill will establish and enshrine in law the powers of this new body, which will have new legal powers to investigate serious patient safety incidents in the NHS in England.
 
The HSSIB will take forward the work of the current Healthcare Safety Investigation Branch (HSIB), which came into operation in April 2017 as a division of NHS Improvement.
 
Under the proposals, the HSSIB will be independent of the NHS and at arm’s length from Government, and will have what has been described as ‘far-reaching’ access to investigate serious safety incidents or risks to patient safety.
 
After each investigation is completed, the HSSIB will publish detailed reports that will: 
  • make recommendations for system-wide learning across the NHS,
  • help develop national standards on investigations, and
  • provide advice, guidance and training to improve investigative practice across the health service. 

 

Creating a ‘Safe Space’

When the HSSIB conducts investigations it will apparently protect the information it holds from disclosure. The Government describes this as creating a ‘safe space’, where the parties involved can share information in the knowledge that it will not be disclosed except in limited circumstances, or by order of the High Court.
 
The aim of the ‘safe space’ is apparently to encourage more participants in investigations to speak out about safety concerns to help identify and address risks across the NHS. 
 

Possible Infringement of Patients’ Rights

However, this feature of the new Bill has been the cause of some concern. Campaign charity Action Against Medical Accidents (AvMA) is worried that it could lead to a serious infringement of patients’ rights and undermine the progress that has been made with the duty of candour and other initiatives to improve trust in NHS investigations.
 
“We have serious concerns about the parts of this Bill which prohibit the disclosure even of information directly relevant to patients’ treatment to the patient/family concerned,” explained Peter Walsh, AvMA’s chief executive. “This is completely at odds with the recommendations of the Expert Advisory Group and the spirit of the duty of candour and NHS Constitution. This is so even if it were only to apply to the new HSSIB. However, the Bill allows for extending this so called ‘safe space’ to local investigations – including trusts investigating themselves.”
 
“We believe this would be against the letter as well as the spirit of the duty of candour and must not be allowed,” he added. “Whilst we welcome the provisions for powers and independence for the HSSIB, of which we are supportive, these affronts to patients’ rights would destroy public confidence in HSSIB and NHS investigations and undermine recent advances made in openness, transparency and a just culture.”
 

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Contains public sector information licensed under the Open Government Licence v3.0.

 

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