Extending safe space powers 'wholly misconceived' warn MPs

In a report scrutinising the government’s draft bill to grant new powers and independence to HSIB, the joint committee of MPs said the proposal would allow NHS trusts to investigate themselves using safe space powers, which means key evidence documents would not be released.

While MPs backed the use of “safe space” for HSIB’s own investigations, they said extending it to NHS trusts needed to be reconsidered. Experts have previously warned this was a dangerous idea.

The report said: “We are convinced this idea is wholly misconceived. It represents too great a conflict of interest for the accredited trusts and would risk damaging confidence in the safe space concept itself. We recommend that this proposal be dropped from the bill.”

MPs said HSIB should be given funding to improve the quality of local investigations through advising and training but asking it to accredit trusts to use its powers “would confuse its role and make it part of the system it is investigating”.

The joint committee did back the premise of safe space investigations by HSIB itself and rejected fears this would lead to families being denied key information.

“We are convinced by the evidence that the ‘safe space’ will only protect information held by the HSSIB. The ‘safe space’ will have no effect whatsoever on any information or evidence already available, or which can still be acquired and made available by existing healthcare bodies and non-HSIB patient safety investigations,” it said.

“HSSIB’s reports will be additional to, not a replacement for, the investigations carried out by trusts, professional regulators, the Care Quality Commission and the Health Service Ombudsman. These assurances address these understandable concerns.”

The MPs criticised former health and social care secretary Jeremy Hunt for asking HSIB to takeover local maternity incident investigations on behalf of NHS trusts. This started in April and will cover around 1,000 cases of stillbirth, neonatal death, and brain injuries.

The MPs said Mr Hunt had “confused” the role of HSSIB by asking it to take this on and that they rejected the bill’s proposal that HSSIB could take on more investigations in the future.

They said: “Much of the concern about HSSIB arises from a fear that it will undermine the duties of trusts, professional regulators, and the courts to investigate harm and provide accountability. There must be a clear distinction between HSSIB’s role — focussing on learning lessons of general relevance without finding blame, and that of the investigations run by other bodies, providing accountability for individual incidents and, if necessary, finding fault.”

Maternity safety campaigner James Titcombe disagreed with the committee and said: “HSIB have already done significant work to build up their expertise and resources, including active recruitment and training of passionate and dedicated staff. This work has the potential to start a step change in the way local organisations investigate and learn.

“In my opinion, it would be tragic if this work was derailed now.”

The committee said HSIB should not be limited to incidents linked to the NHS and should be extended to include other health and social care providers, including the private sector.

It also recommends a number of changes to the legislation to grant HSIB more independence from the government and provide for accountability to Parliament.

The government will decide whether to reject or accept the recommendations and change the draft legislation which could then be brought forward for MPs to vote on but this is not expected to take place until after the current Parliamentary session.

The legislation is due to change the name of Health Service Safety Investigations Body.