NMA: Draft Bill Would Allow NHS Trusts to Investigate Themselves and Prevent the Disclosure of Information

In written evidence to the Joint Committee on the Draft Health Service Safety Investigations Bill, the NMA has criticised a draft Bill that would allow NHS Trusts to investigate themselves without having to disclose any information used in the investigation beyond a final report that would be largely based on recommendations.

Under the terms of the Draft Health Service Safety Investigations Bill, when either the Health Service Safety Investigations Body (HSSIB) or an approved NHS Trust investigate a serious patient safety incident, there would be a blanket statutory ban on the release of any information held in connection with the investigation other than the final, published report.

The proposals are intended to improve the quality of investigations by creating a “safe space” for those involved to discuss candidly what happened, but the NMA criticised the Bill as a threat to patient safety and public confidence in the health system. 

In its submission, the NMA said: “The blanket ban on the release of information not detailed in the recommendations-based report will undermine public confidence and patient safety, not improve it.  The public and other stakeholders will not be able to assess the rigor of the investigation, the propriety of the recommendations, or whether improvements are being made if they do not have access to the information on which the recommendations are based.

“This ability to self-investigate and then prevent disclosure will greatly damage public trust in the system, and the lack of transparency generates a significant risk of abuse. The draft Bill attempts to mitigate this through an accreditation mechanism, and the Committee has asked whether these accreditation provisions are satisfactory. However, these problems are unlikely to be remedied by accreditation – public concern of about a conflict of interest arising from the NHS investigating itself and producing reports whose underlying evidence cannot be verified will remain. The power to prevent disclosure will damage, not improve, public confidence and patient safety.”

The NMA was not alone in its concerns that the proposals could be detrimental. The Professional Standards Authority for Health and Social Care  emphasised in their evidence “that patient safety depends upon a learning culture, where near misses and errors are openly discussed and learnt from.  The rights and needs of patients and their families, the accountability of professionals and the requirements of effective regulation. However, an open culture where information is shared between professionals must not be closed to patients and the public should not be disregarded.”

The NMA also criticised the Bill for being in conflict with data protection legislation, as it could prevent people from accessing their personal data held in connection with an investigation.