New national body to take powers from scandal-hit watchdog

Sajid Javid told the Commons today that a new special health authority would be established to run the national maternity investigation programme, which is currently a responsibility of the Healthcare Safety Investigations Branch.

HSIB was set up in 2017, by the then health secretary Jeremy Hunt, as a non-statutory body, run as an organisational arm of NHS Improvement, but overseen by the Department of Health and Social Care.

As HSJ revealed on Friday, an official, external review of HSIB last year found huge problems with its culture and leadership, including concerns about senior maternity investigation team leaders. Its chief inspector is due to leave shortly.

However, the reason put forward for the new body is that imminent “safe space” legal changes to HSIB will mean evidence given to it must be kept private – a measure which is not wanted for maternity investigations. A switch away from HSIB had been expected for several years.

The Health and Care Bill, currently going through Parliament, would give HSIB statutory independence as the Health Service Safety Investigations Body. Mr Javid said the maternity programme was not included in this, “because conducting investigations under ‘safe space’ is a key element… [whereas maternity] investigations do not follow ‘safe space’ principles”.

HSIB became responsible for conducting independent investigations relating to intrapartum stillbirth, early neonatal death, or severe brain injury diagnosed in the first seven days of life, and maternity deaths, in April 2018.

“In 2020-21, the Maternity Investigation Programme completed 1,024 reports and made more than 1,500 safety recommendations to individual NHS trusts, addressing a wide array of issues,” Mr Javid said.

The new health authority, which has not been given a name, will:

• provide independent, standardised, and family-focused investigations of maternity cases that provide families with answers to their questions about why their loved ones died or were seriously injured;
• provide learning to the health system at local, regional and national level via reports for the purpose of improving clinical and safety practices in trusts to prevent similar incidents and deaths occurring;
• analyse the incoming data from investigations to identify key trends and provide system-wide learning in these areas
• be a system expert in standards for maternity investigations and support trusts to improve local investigations;
• collaborate with system partners to escalate safety concerns and share intelligence.

It will be established for up to five years from 2022-23 to “enable maximum learning to be achieved and to equip NHS trusts with the expertise, resources, and capacity to take on maternity safety incident investigations in the future”.

Commons health committee chair and safety campaigner Jeremy Hunt, who established HSIB when he was health secretary, has indicated he is opposed to transferring maternity investigations to a new body. He said: “Surely any issues there can be sorted out by new leadership without the upheaval of setting up yet another independent body to do these vital reports.”