Healthcare Safety Investigation Branch (HSIB)

Will air safety standards influence healthcare in the future?

In July 2015 Jeremy Hunt, Secretary of State for Health announced the formation of a new Independent Patient Safety Service. This followed the Public Administration Select Committee Report in March 2015 which stated that hospital investigations were:

Complicated, take far too long and are preoccupied with blame or avoiding financial liability.’

Also in the background were the Morecambe Bay enquiry following tragic deaths in maternity services and the NHSLA report of 2014/15 reporting annual safety statistics:

  • 30,000 serious reportable incidents (of which 10,000 were patient safety incidents resulting in severe harm or death)
  • More than 300 never events

Since last summer an Expert Advisory Group (EAG) has been meeting on a fortnightly basis to consider the terms of reference for the service which is due to start work formally in April 2016. Ahead of the launch, a change of name has been announced with the service now being called the Healthcare Safety Investigation Branch (HSIB).

The EAG has drawn on expertise generally from within the healthcare system but interestingly one of the key advisors is Keith Conradi, Chief Inspector of the Air Investigation Branch. With the new name now echoing that of the body tasked with investigating air accidents, it remains to be seen whether the work it will undertake will be similar to that of the Air Investigation Branch. The airline industry as a whole is seen as setting exceptionally high safety standards and despite significant fatalities when there is an airline disaster, generally air travel is perceived as relatively safe.

To achieve these high standards, the airline industry relies on drilling and repeated training with checklists commonly used to deliver a uniform service. Training aims to encourage groups to function as teams rather than a collection of individuals, to ensure that they work cohesively together, have enhanced communication skills and juniors are encouraged to voice concerns.

The Investigation Branch will not be responsible for training and delivering services but it should have the opportunity to change the focus on safety to try and improve outcomes and reduce avoidable incidents of harm by feeding back on why there has been a poor outcome.

Whether it is able to do so depends on whether it can realistically make a difference when it will only be resourced to investigate a modest percentage of the safety incidents that arise annually in our hospitals. If it is really going to make a difference there must be the political will to support its findings and deliver true change within a healthcare system that struggles through lack of proper investment in people, skill training and willingness to innovate, to produce results.

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