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Support a learning culture in the NHS

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As the Health and Health Care Bill faces its last parliamentary hurdle this week – returning to the House of Commons for “ping pong” after numerous amendments to the House of Lords, Thomas Reynolds, head of government and foreign relations at the Union for Health Protection (MDU). explains why we urge the government to adopt changes to the bill that will support an effective investigation after adverse events.

The Health and Medical Care Bill is the flagship piece of legislation for the government. This has sparked significant debate in the medical community and beyond. It is also a bill that covers many areas: from defining comprehensive NHS England care and restructuring boards to setting advertising conditions for food and drink. For the MDU, one of the most important aspects of the bill is the formal establishment of the Health Safety Investigation Division (HSIB) as a statutory independent body – the Health Services Safety Investigation Authority (HSSIB).

An important feature of the new HSSIB is the “safe space” that this legislation creates during its investigations. The goal of the Safe Space is to encourage health professionals to engage fully and openly without fear or guilt due to the HSSIB’s ban on disclosing information obtained during investigations following adverse patient safety events – with a few exceptions.

One such exception is the disclosure of information to the coroner. This is a small but fundamentally important point.

Since the bill was published last year, the MDU is strongly campaigning to ensure the removal of coroners from the list of exceptions – and with it their ability to access information in a secure space. The House of Lords voted by a large majority in favor of the amendment of Lord Hunt of the Heath Kings, which does just that.

The MDU calls on the government to adopt this amendment and urges MPs to support it.

If co-ordinators are allowed to regularly request access to information stored in the HSSIB – naming individual doctors and other health professionals – then we fear that “safe space” may fail in the eyes of NHS staff even before it begins. This is due to the fact that the consequences of having their name in the investigation of the coroner can be serious – for example, the possibility of being involved in the suitability of the practice of investigating the regulator.

For HSSIB investigations to yield the results we all want to see, with improvements identified in the interests of patient safety, it is vital that the safe space is as reliable as possible – as safe as possible.

The creation of the HSSIB is such a positive step forward for the NHS. This is a significant moment on the way to cultivating an open, educational, innocent culture. Safe space is at the heart of this. We urge the government to adopt the amendment and introduce the HSSIB, which can inspire confidence in the profession.

Do you agree with us? If so, you can write to your MP and urge them to support the MDU campaign.

If you don’t know your MP’s contact information, you can find them here by entering your home zip code. If you are contacting your MP about the bill, please let us know.

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