Creating a safe space in investigations: The Health and Care Bill and the creation of the Health Services Safety Investigations Body

As MPs begin detailed scrutiny of the Health and Care Bill, MDU head of government and external relations, Thomas Reynolds, explains why we are urging MPs to make a small but crucial amendment to the legislation.


A learning culture in the NHS is something that has to be constantly nurtured, and the Health and Care Bill has a role to play in that; specifically, the formal inception of the Healthcare Safety Investigation’s Branch (HSIB) as a statutory, independent arm’s length body – the Health Services Safety Investigations Body (HSSIB).

The success of the new organisation will, like its forerunner, depend on effective collaboration and communication with doctors and their colleagues across the healthcare system, as well as with patients and their families.

For the HSSIB’s investigations to yield the results we all want to see, with improvements identified in the interests of patient safety, it is vital that the much vaunted ‘safe-space’ in this legislation –– is as robust and as safe as possible.

This is so healthcare professionals can engage with the HSSIB’s investigations without fear or blame and is why we are proposing an amendment to the Bill – and urging MPs to back it.

We are concerned that the Bill, as currently drafted, allows for coroners to be exempt from the prohibition of disclosure of HSSIB material. This would mean that individual coroners could routinely request material from the HSSIB’s investigations – naming individual doctors and other healthcare staff.

To ensure that the HSSIB’s ‘safe-space’ can work as effectively as possible; support the engagement of healthcare staff; reduce the prospect of fear and reluctance to engage with investigations and maximise the chances of HSSIB reports yielding meaningful improvements in patient safety - coroners should be removed from the list of exceptions to the prohibition on disclosure of HSSIB material.

Otherwise, it could affect healthcare professionals’ willingness to be fully engaged and open with HSSIB investigations. Especially given the potential consequences of being named in a coroner’s investigation such as a Fitness to Practise investigation by their professions regulator.

The creation of the HSSIB is such a positive step forward for the NHS. It is a landmark moment in the journey towards fostering an open, learning, no-blame culture. That is why the ‘safe-space’ that this Bill creates at the very centre of the HSSIB is so important. That safe space needs to inspire the confidence and trust of those who will be engaging with it; this is precisely why Schedule 14 (6) should be removed from the Bill. It is a simple amendment, but one that could make a big difference.

Read our briefing to MPs.

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

If you don’t know the contact details for your MP, you can find them here by typing in your home postcode. If you do contact your MP about the Bill, please do let us know.

This page was correct at publication on 09/09/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.

Thomas Reynolds

by Thomas Reynolds Head of government & external relations

Thomas (Tom) has worked in the medico-legal sector since 2014, prior to which he was employed in the House of Commons as a parliamentary researcher and adviser to a number of MPs. He is a graduate of the University of Exeter, where he studied Politics, Law and International Relations. Tom has a long academic interest in medical ethics, beginning with his undergraduate dissertation which examined the law on abortion in England and Wales. In addition to his role at the MDU, he is also a magistrate for the Central London district.