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New NHS safety investigator must become fully independent body

The new NHS safety investigator for England, which starts work in April 2017, must become a fully independent body through primary legislation, according to healthcare safety experts writing in the Journal of the Royal Society of Medicine. As an interim measure the Healthcare Safety Investigation Branch (HSIB) has been formed as a functionally independent body under the auspices of regulator NHS Improvement.

The HSIB will systematically and routinely investigate the most serious risks to patient safety across the healthcare system, publicly report on its findings and issue recommendations for improvement. Investigations will be solely for the purpose of learning and will explicitly avoid allocating liability or blame.

Lead author Carl Macrae, University of Oxford, said: “Remarkable progress has been made in forming the HSIB in less than two years since a Parliamentary select committee inquiry in 2015. This represents a watershed moment as the NHS becomes the first healthcare system in the world to have a specialist safety agency dedicated to investigating and learning across the entire healthcare system.”

But the authors say it is hard to overstate the critical importance of independence for a national safety investigator. Co-author Charles Vincent, University of Oxford, said: “Safety issues span the entire healthcare system, so the HSIB must be able to impartially investigate all organisations entirely free from conflict to build an authoritative system-wide view.”

Without complete independence, say the authors, the HSIB will have to work unnecessarily hard to combat the perception that it remains part of the regulatory establishment.

Carl Macrae said: “It is imperative that primary legislation is brought forward to establish the HSIB on an independent institutional footing. To encourage the open flow of safety information, healthcare professionals and organisations must be assured that any information generated solely for the purposes of safety investigation – such as witness statements or investigators’ notes – will only be used for the purposes of learning and will not be routinely passed to regulators or courts.”

Notes to editors

A new national safety investigator for healthcare: the road ahead (DOI: 10.1177/0141076817694577) by Carl Macrae and Charles Vincent, will be published by the Journal of the Royal Society of Medicine at 00:05 hrs (UK time) on Friday 10 March 2017.

The link for the paper when published will be:

For further information or a copy of the paper please contact:

Rosalind Dewar
Media Office, Royal Society of Medicine
DL: +44 (0) 1580 764713
M: +44 (0) 7785 182732

The JRSM is the flagship journal of the Royal Society of Medicine and is published by SAGE. It has full editorial independence from the RSM. It has been published continuously since 1809. Its Editor is Dr Kamran Abbasi.

Sara Miller McCune founded SAGE Publishing in 1965 to support the dissemination of usable knowledge and educate a global community. SAGE is a leading international provider of innovative, high-quality content publishing more than 1000 journals and over 800 new books each year, spanning a wide range of subject areas. A growing selection of library products includes archives, data, case studies and video. SAGE remains majority owned by our founder and after her lifetime will become owned by a charitable trust that secures the company’s continued independence. Principal offices are located in Los Angeles, London, New Delhi, Singapore, Washington DC and Melbourne.

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