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HSIB’s journey to full statutory independence

In September 2017, the Government published the draft Health Service Safety Investigations Bill, which proposed to establish the Health Service Safety Investigations Body (HSSIB) as a statutory body, independent of the NHS and at arm’s length from government.

The HSSIB would have powers to investigate for the sole purpose of learning, not to attribute blame or individual fault, providing a safe space for staff and patients to be open and candid when things go wrong.

With this approach, the HSSIB would become an exemplar of healthcare safety investigative practice, helping embed a culture of learning across the NHS in England.

The draft Bill underwent pre-legislative scrutiny by a Joint Committee of the House of Lords and House of Commons from May to July 2018. The Committee published its report in August 2018 and the government published a response to this report in December 2018.

The Health Service Safety Investigations Body (HSSIB) Bill was subsequently introduced in the House of Lords in October 2019, and had progressed to second reading stage prior to the calling of the General Election of 12 December 2019.

The Health and Care Bill

The government reaffirmed its commitment to establishing the HSSIB in the White Paper, Integration and Innovation: Working together to improve health and social care for all, published in February 2021, which set out proposals for a Health and Care Bill to be introduced in this Parliament.

The Health and Care Bill has since been presented in the House of Commons by the Secretary of State for Health and Social Care on 06 July.

Part 4 of the Bill (clauses 93 - 119) establishes the Health Service Safety Investigations Body (HSSIB). The proposals include:

  • the HSSIB being established as a non-departmental public body (NDPB) reporting to the Secretary of State for Health and Social Care, but with full operational independence of the Department for Health and Social Care
  • provisions to ensure that investigations undertaken by the HSSIB are expressly for the purpose of learning to improve safety, not for apportioning blame or liability
  • the HSSIB must determine and publish investigation criteria, principles, and processes for investigations including procedures and methods, and timescales, and processes for involving patients and families in ways that are easily accessible and understood
  • information gathered by the HSSIB during it investigations subject to confidentiality protections through prohibition on disclosure, or ‘safe space’ protections, access to which can only be granted by the High Court – with an exemption for coroners
  • investigatory powers that compel witnesses by law to give evidence and for organisations to provide access to materials, equipment and records that HSSIB considers necessary for the investigation
  • remit to develop standards for the NHS in England on conducting patient safety investigations, and to provide advice, guidance and training for NHS and other organisations, with certain caveats.

In addition, the Bill expands the remit of the HSSIB to encompass all healthcare, including that provided by the independent sector in England.

It also includes powers for the Secretary of State to direct the HSSIB to undertake investigations into particular qualifying incidents and to exempt investigations from ‘safe space’ protections.

The Bill had its second reading on 14 July 2021, and will continue its passage through the House of Commons stages after the Summer recess. We expect that HSIB’s Chief Investigator, Keith Conradi, will give evidence to the Bill Committee as part of this process.

The Bill is expected to move to scrutiny but the House of Lords in the early winter and to receive Royal Assent by the end of the financial year.

You can follow the passage of the legislation on the webpage for the Bill here.

Further updates on the passage of the legislation as it relates to the establishment of the HSSIB, including any briefing materials produced by HSSIB, will be posted on this page in due course.