GPs to fall under remit of new patient safety watchdog from 2023

GP practices will be included in the remit of a new patient safety watchdog, due to come in from 2023 under the new Health and Care Bill, the Department of Health and Social Care (DHSC) has said.

The bill, which includes powers that will see CCGs abolished and replaced with new integrated care systems (ICSs), was introduced to Parliament in July, following publication of a white paper in February this year.

In an ‘impact assessment’ for the bill, published earlier this month, the DHSC said that it expects the new Health Services Safety Investigations Body (HSSIB) to be ‘fully operational’ in England from April 2023 – ‘subject to parliamentary clearances’.

It confirmed that the statutory independent body will investigate NHS care in GP practices, although it said that the HSSIB’s ‘focus is likely to be predominantly on investigating patient safety incidents in NHS trusts’.

The body will also investigate care provided by the independent healthcare sector.

The HSSIB will investigate serious incidents or risks to patients with ‘safe space’ protections for NHS whistleblowers, patients or their families, meaning information shared as part of an investigation will not routinely be made public.

It will also be given ‘appropriate powers, including enforcement via criminal sanctions, so that it can discharge its investigative function’, the DHSC said.

These include statutory ‘powers of entry and inspection’ to enable HSSIB to enter premises without the need for a warrant and the power to ‘compel individuals to attend for interview’, it added.

The DHSC said the body’s investigations will aim to ‘improve safety across the healthcare system by determining the systemic causes of serious safety issues and to identify system-wide learning to make safety recommendations that are intended to reduce risks to patients’.

The document added that it will have three main functions:

• Undertaking up to 30 investigations per year;
• Supporting improvements in the ‘quality and effectiveness’ of local safety investigations;
• Encouraging the ‘development of skills’ by disseminating learning from incidents.

The health secretary has ‘committed’ to introducing the new body via the Health and Care Bill ‘in summer 2021’ but the new policy will be reviewed in 2024/25, it said.

The HSSIB will have expanded remit and powers compared with the Healthcare Safety Investigations Branch (HSIB) – a similar body that has been operating since 2017 but did not have independent statutory footing.

RCGP vice-chair Dr Gary Howsam said: ‘It is important that we have further details about how this regulator will interact with general practice, and the expectations it will have of GPs and our teams, including ensuring GPs are not implicated for systemic issues out of their control.’

He added: ‘GPs already work under significant bureaucratic requirements that draw them away from where they are needed most.  

‘It is essential that this new regulatory body doesn’t duplicate the work already required by other regulators like the CQC, and that GPs can focus on delivering the best care for their patients rather than completing new paperwork requirements.’

In 2017, the DHSC confirmed that GP practices would be within the scope of the HSSIB’s investigations when the draft bill was first laid before Parliament.

Meanwhile, the BMA passed a resolution calling for MPs to reject the new Health and Care Bill in July, arguing it is ‘not the right time’ to be bringing in widespread legal reforms while the NHS deals with the Covid-19 pandemic.

The Health and Care Bill 2021/22 proposals, first published in a white paper in February, will also see ICSs placed on a statutory footing so they become responsible for commissioning and bringing together local NHS and local government services, such as those covering social care and mental health.

As previously published in our sister title Pulse