New NHS investigative body to examine suspicious deaths

Sarah Boseley Health editor
The government says the body is designed to provide a ‘safe space’ for NHS staff to be open about what went wrong when a patient unnecessarily died. Photograph: Peter Byrne/PA

A new body being set up to investigate suspicious deaths in the NHS will be so secretive it will block families from finding out the truth of what happened to their relatives, campaigners have said.

The government says the Health Service Safety Investigations Body is designed to provide a “safe space” for doctors, nurses and other NHS staff to be open about what went wrong when a patient died or was harmed unnecessarily. The proposal for setting up the body is currently with a joint committee in the Houses of Parliament.

Earlier this week the report into Gosport hospital, which found more than 450 older people had died after being given life-shortening opioids, found that many who worked in the hospital had tried to raise the alarm but their complaints had not gone any further.

Campaigners have expressed concern that the investigative body will be prohibited from disclosing any information, even when it is neither personal nor damaging. It will be banned from revealing a hospital’s staffing or financial data that might have contributed to an untimely death.

Maurice Frankel, the director of the Campaign for Freedom of Information, said all that relatives, patients, campaigners and even MPs would see was the final report.

“It will introduce a new layer of secrecy into the NHS over and above anything that exists at the moment, which the investigators themselves will have no power to overcome,” he said.

“If it is not published in the report, they will have no power to disclose it. We are going to see the shutters come down around the whole system of accident investigation in a way that is very unhealthy and it is going to damage people’s confidence in the system.”

The Department of Health is modelling the body on the Department for Transport’s Air Accident Investigations Branch. Frankel pointed out that the last passenger death on a commercial airline in the UK was in 1999. There are an estimated 12,000 avoidable deaths and 24,000 serious incidents in the NHS each year.

“The whole country is going to be affected by this. It will lead to suspicions of cover-ups and that suspicion will probably be justified,” he said.

Families of older people who died in Gosport War Memorial hospital in the 1990s battled for 20 years to persuade officials to believe them and find out what happened. The report, from an expert panel that examined all the documentation it could access, concluded that 456 people died after being given life-shortening doses of opioid drugs on the wards over a period of 12 years.

Jeremy Hunt said the scandal exposed the “blame culture” in the NHS. “The basic problem is that if you are a doctor or a nurse and you see something going wrong … the thing that families want, if they are bereaved or have a tragedy, is to know that the NHS isn’t going to make that mistake again,” the health secretary said on BBC radio.

“We make it much too hard for doctors and nurses to do that. They are worried that there will be litigation, they will go up in front of the GMC [General Medical Council], or the NMC [Nursing and Midwifery Council].”

Hunt added: “In some places they are worried they might get fired. So we do have to tackle that blame culture and turn that into a learning culture.”

Frankel, however, said the secrecy of the investigatory body would not change the reluctance of doctors and nurses to admit fault, because the draft bill allows it to pass information to the police, the GMC or the NMC, which can end doctors’ and nurses’ careers.

Writing in the Guardian, Peter Walsh, the chief executive of Action Against Medical Accidents, which supported the Gosport families in trying to get inquests held, criticised the new body.

“It is hugely controversial, as it would introduce something it calls a ‘safe space’ in patient safety investigations. This is defined in the bill as a prohibition on sharing any information obtained in an investigation,” writes Walsh.

That prohibition, he says, means even a patient who was the victim of an incident, would not be able to see the information. “Nor could they use any facts in the final published report to seek justice through the civil courts or tribunals. There doesn’t seem much candour in that.

“This measure, if it is allowed to go ahead, would destroy any trust that patients or families could have in NHS investigations, and lead to a more adversarial culture where people turn to legal action and seek disciplinary action straight away.”

A Department of Health and Social Care spokesperson said: “We are committed to improving patient safety in the NHS and supporting staff to speak up is a vital part of that. It’s clear from incident investigations in aviation and rail sectors that staff are more encouraged to speak up about concerns in a safe space.”