Proposals to transfer the Health Services Safety Investigations Body functions to the Care Quality Commission dropped

This week the UK Government has dropped its plans to abolish the Health Services Safety Investigations Body (HSSIB) and transfer its functions to the Care Quality Commission (CQC).

Background

Last summer the Department of Health and Social Care (DHSC) published the findings of its review of patient safety across England, chaired by Dr Penny Dash.[1] This review proposed several changes which sought to coordinate and rationalise patient safety roles and responsibilities. One of those recommendations was that the functions of HSSIB should be transferred to the CQC.

HSSIB investigates patient safety concerns across the NHS in England and in independent healthcare settings where safety learning could help to improve NHS care. It is currently an executive non-departmental public body sponsored by DHSC.

The proposal to abolish HSSIB and transfer its functions to the CQC was included in the new Health Bill which is currently progressing through Parliament.

Concerns about the change

The Patient Safety Management Network (PSMN), hosted on the hub, held a discussion about this proposed change earlier this year. The PSMN is an innovative voluntary network for patient safety managers and everyone working in patient safety. They highlighted several concerns about this proposal, most notably:

• Concerns about combining HSSIB’s investigative role with the CQC’s regulatory and inspection functions, including potential conflicts of interest and reduced staff confidence in sharing information openly.

• Despite assurances that existing ‘safe space’ legal protections would be retained, members questioned whether these protections would remain secure in the long term and whether staff would continue to perceive them as trustworthy.

Similar concerns had also been highlighted by Professor Carl Macrae, Sir Bernard Jenkin MP and the All Party Parliamentary Group on Patient Safety.

New amendments in the House of Lords

The Health Bill is currently being scrutinised by the House of Lords. Yesterday, Health Service Journal reported that Baroness Merron, the DHSC minister in the Lords, had sent a letter stating that the government, after listening to concerns about this proposal, has decided not to proceed with this.

This has been confirmed in the latest running list of amendments to the Bill, which now includes the Minister’s intention to leave out Schedule 9 of the legislation, which transfers the Health Services Safety Investigations Body’s functions to the Care Quality Commission.

Patient Safety Learning's response

In our response to the Dash Review, Patient Safety Learning stated our belief that HSSIB has an important independent role in the health system which should be retained. We subsequently expressed our view that the provisions included in the Health Bill did not effectively address the concerns about this proposal raised by MPs, members of the Patient Safety Management Network and patient safety campaigners. We therefore welcome this decision to retain HSSIB's independent investigative function and to not proceed with plans to move this into the Care Quality Commission.