Safety and quality and the NHS White Paper

Next in our series of blogs on the NHS White Paper we review new proposals on safety and quality.

Annex A of the White Paper sets out four themes one of which is called (rather uninspiringly and without giving much away) “Additional Proposals”. 

This contains some 14 proposals relating to social care, public health and safety and quality.

Looking just at safety and quality the following measures are worthy of particular note:

Health Service Safety Investigations Body

Readers will be familiar with the work of HSIB (Healthcare Safety Investigation Branch). There had been a Bill in October 2019 that got waylaid by Brexit and the coronavirus pandemic which proposed creating a slightly renamed independent body.

HSSIB will be established as a Non Departmental Public Body (NDPB).

In particular the proposals are to:

• Prohibit disclosure of information held by HSSIB in connection with its investigatory function save in limited circumstances set out in the Bill. The aim being to create a “safe space” whereby participants can provide information to HSSIB for the purposes of an investigation in confidence and, therefore feel able to speak openly and candidly with the HSSIB. This is a controversial proposal. 
• Encourage the spread of a culture of  learning through promoting better standards for local investigations and improving their quality and effectiveness. HSSIB will provide advice, guidance and training to organisations.
• Extend HSSIB’s remit to cover healthcare provided in and by the independent sector.
• Introduce a power to enable the Secretary of State to require the HSSIB to investigate particular qualifying incidents or groups of qualifying incidents.

Finally, the Bill will also include a regulation-making power allowing the Secretary of State to set out additional circumstances when the prohibition on disclosure (safe space) does not apply.

Medical examiners

Legislation is to be amended to establish a statutory medical examiner system within the NHS for the purpose of scrutinising all deaths which do not involve a coroner. The Coroners and Justice Act 2009 will be amended to allow for NHS bodies (not Local Authorities) to appoint medical examiners. Once they are in place, the Government want to ensure that every death in England and Wales is scrutinised either by a coroner or a medical examiner.

This proposal has many aims:

• To improve the accuracy of the cause of death;
• To improve the accuracy, subsequently, of  mortality statistics;
• Increase transparency for the bereaved;
• Help deter criminal activity; and
• Help deter poor practice.

You can read our earlier blogs on the NHS White Paper proposals on service configurations here and discharging patients here.