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Health Service Safety Investigations Body is vital to improve patient care, says RCN

Independent body would provide a safe space for whistleblowers to provide information for patient safety investigations

Independent body would provide a safe space for whistleblowers to provide information for patient safety investigations

A new NHS whistleblowing service to prevent patient harm must be fully independent, MPs have warned.

Donna Kinnair
RCN director Dame Donna Kinnair: 'The Health Service Safety Investigations Body is an important
step in creating a culture that prioritises learning, not blame, which is vital for patient safety.'
Picture: John Houlihan

Plans to establish a Health Service Safety Investigations Body (HSSIB) to investigate cases of compromised patient safety have been supported by a joint Lords and Commons' committee.

The independent statutory body would also provide a 'safe space' for NHS staff and patients to provide confidential information for the purpose of an investigation.

However, the government proposal to accredit NHS trusts to conduct internal investigations should be dumped, said joint committee chair Sir Bernard Jenkin.

Conflict of interest

In his report, Sir Bernard said: 'The committee considers this idea to be wholly misconceived.

'It represents too great a conflict of interest for the accredited trusts, compromises HSSIB's independence from the system it is investigating and would risk damaging confidence in the 'safe space' concept itself.

'To win the confidence of patients, healthcare practitioners and other bodies with responsibility for patient safety, HSSIB had to be, and be seen to be, independent of existing healthcare structures, including the Department of Health and Social Care.'

With an estimated 12,000 avoidable hospital deaths every year, the committee said change is clearly needed for the benefit of patients and staff.

Learning culture

Responding to the report, RCN director of nursing, policy and practice Dame Donna Kinnair said the college welcomed the body's independence from government and trusts. She said this is vital to ensure trust and robust recommendations that lead to improvements in patient care.

'HSSIB is an important step in creating a culture that prioritises learning, not blame, which is vital for patient safety,' Professor Kinnair said.

 'Healthcare is beginning to be recognised as a safety critical industry, and with safeguards in place, will allow staff to discuss incidents without fear of retribution or being scapegoats for wider systemic problems.

'The nursing shortage is central to many of the issues facing our healthcare system, and it’s positive to see HSSIB will be free to reflect what is a major patient safety concern. We expect reporting on staff numbers to become standard practice for every investigation HSSIB undertakes.'

Social care role

Professor Kinnair added that the college welcomed the committee's recommendation to expand the body's role to include parts of social care, saying that 'systemic issues seldom arise in a vacuum'.

'Patients should feel confident that when things go wrong they will be investigated, and lessons learned, regardless of the setting,' she said.

Nursing and Midwifery Council general counsel Clare Padley, who gave evidence to the committee, said: 'We were very pleased to have been involved in the discussions surrounding this vital issue and to see that the committee has taken on board many of the points we raised. We believe that prioritising learning and creating a culture of openness and transparency across the whole healthcare and regulatory sector is crucial to improving patient safety.

'We will now consider the report in detail and look forward to engaging with the government as they take this legislation forward.  We will also continue to engage regularly with HSIBB in its current form.'

Related materials

The joint committee's inquiry


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