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23.11.16

‘Strong argument’ for legislation to enforce HSIB, says health minister

The health minister has said there is a “strong argument” for primary legislation to support the new Healthcare Safety Investigation Branch (HSIB), but insisted that introducing it was out of his control at a Public Administration and Constitutional Affairs Committee (PACAC) hearing.

Earlier this year, the PACAC warned that current arrangements for HSIB, where it has no legal protection for its independence and is part of NHS Improvement instead of the Department of Health, constitute “an intolerable compromise”.

Appearing before committee members yesterday, Philip Dunne admitted that there will be no primary legislation to support HSIB when it officially opens on 1 April 2017, but said there could be scope for introducing legislation later.

“There is a strong argument for there to be primary legislation,” he said. “I cannot answer your question because I’m not aware what’s in the Queen’s Speech, but I’m well aware that in order to deliver it in the optimum way, it would be required.”

Keith Conradi, who is due to act as chief inspector of HSIB, has said that the branch will need legislative powers to function.

Furthermore, Dunne described the purpose of HSIB as “to try to change the culture of the NHS from one of blame to one of learning from mistakes”.

He said he wanted to create a culture where staff “feel free to speak openly” about safety concerns, but added that this would take “considerable efforts”.

HSIB will have a £3.8m budget and conduct around 30 investigations a year. William Vineall, director of quality at the Department of Health, who also gave evidence in the hearing, said the organisation had been deliberately designed as “a bespoke body” that would exert “downward pressure” on the NHS to improve local investigations, instead of carrying out all safety investigations on its own.

The PACAC has recommended using legislation to protect the concept of a ‘safe space’ in investigations, after an expert advisory group warned that staff currently see safety investigations as “threatening”.

Vineall said the “intent” was to apply the safe space to HSIB investigations, but that it depended on legislation.

When asked by MPs whether safe space legislation could apply to local investigations as well, he agreed that this was desirable because it would create a “virtuous circle” in improving the quality of investigations.

He also said he was waiting for feedback on a consultation into HSIB, which contains a number of proposals, including introducing safe space regulations in stages so that they apply to local investigations in controversial areas such as maternity care first.

In addition, Vineall suggested that HSIB could accredit organisations to carry out local investigations.

When asked to clarify HSIB’s relationship to other organisations such as NHS Improvement and the CQC, he replied that it would produce “significant new material of a high quality” that these organisations would use to “take forward the learning” in trust interventions.

Dunne also said HSIB was not going to “hit the ground running with a set of procedures”, but would instead learn from implementing each investigation.

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