ISCAS – Patient Safety Bill must include private patients

Houses of Parliament

ISCAS is extremely disappointed to see that the new Health Service Safety Investigation Bill (HSSIB) is moving forward without the inclusion of the independent sector.

In our written evidence submission in 2018 to the Joint Committee on the draft HSSIB, we included:

ISCAS considers that the HSSIB will only command the confidence of patients and their families and healthcare professionals if it has a remit across healthcare, whether this is the NHS or in the independent sector. Indeed the foreword by the Secretary of State refers to “whole-system” change. …The stated function of the HSSIB is for addressing risks to the safety of patients by facilitating the improvement of systems and practice. This aligns with the stated objectives of the systems regulators, for example CQC state – ‘we make sure health services provide people with safe, effective, compassionate high quality care and we encourage services to improve’. Therefore it would seem appropriate that the remit of any HSSIB aligns with the registration, monitoring and inspection of healthcare services, whether NHS or independent sector.”

In January 2019 ISCAS wrote that it agreed with the Joint Committee’s recommendation that the draft Bill should be amended to extend the remit to the provision of all healthcare in England, however funded. Unfortunately the current drafting only includes NHS-funded care. 

During the second reading in the House of Lords there were numerous references to the Independent Inquiry into the issues raised by Paterson. The terms of reference for that Inquiry includes theadequacy of the response to patients following adverse incidents, including clinical recall, in both the independent sector and the NHS.

Patient pathways, the way staff are engaged and locations in which patients are treated do not divide clearly, or in a binary manner between the NHS and the independent sector. It cannot be right that a group of patients could be treated by the same personnel, but in differently funded locations, and yet their entire pathway was not considered within scope of an investigation. Similarly, how could patient safety be said to be served if a private patient’s care in a NHS private patient unit (NHSPPU) is excluded from an investigation, whilst the treatment of a NHS patient in an independent sector hospital is included in an investigation. 

ISCAS is aware of how historic anomalies in the complaints handling system creates difficulties for patients moving between NHS and private treatment. That lesson should have been learned and not replicated when drafting the new Bill. Therefore, ISCAS will be calling for the Bill to be amended to ensure that all healthcare is included within scope of investigations.