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Patient safety watchdog to be given expanded powers to investigate GP incidents from 2023

Patient safety watchdog to be given expanded powers to investigate GP incidents from 2023

A patient safety watchdog will be given new and expanded powers to investigate incidents that take place in GP practices 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.

The expanded Health Services Safety Investigations Body (HSSIB) will have new powers compared with the Healthcare Safety Investigations Branch (HSIB) – a previous iteration of the body that has been operating since 2017 but did not have independent statutory footing.

GPs have been included in the remit of the patient safety watchdog since 2017, when the HSIB was set up.

In an ‘impact assessment’ for the bill, published earlier this month, the DHSC said that it expects the expanded HSSIB to be ‘fully operational’ in England from April 2023 – ‘subject to parliamentary clearances’.

It confirmed that the statutory independent body will continue to 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 begin investigating care provided by the independent healthcare sector under the bill’s updates.

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’.

An HSIB spokesperson stressed that the body is ‘not a regulator’ and that it is ‘prohibited from attributing blame’.

HSIB deputy medical director Dr​ Lesley Kay told Pulse: ‘We do not have any enforcement powers for our findings or recommendations and are specifically prohibited from attributing blame or liability.

‘The enforcement powers that may come with the bill relate only to access to materials, records and interviews to provide evidence for our investigations.’

The document added that the HSSIB 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.

In 2017, the DHSC first confirmed to Pulse that GP practices would be within the scope of the body’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.

Health minister Jo Churchill has said the bill will ‘do away with unnecessary bureaucracy’ for GPs, in an exclusive op-ed for Pulse.

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.

Note: This article was updated at 16.15 on 1 October to correct inaccuracies regarding HSSIB’s role.



Please note, only GPs are permitted to add comments to articles

Honest Fromyorkshire 29 September, 2021 10:37 am

Here we go again.

Cameron Wilson 29 September, 2021 11:31 am

Dearie me! Presumably someone somewhere thinks idea’s like this will actually help!! Add this to the usual rogues of CQC,GMC,NHSE all who don’t work on the front but know exactly how they would!! Laughable and deluded! The masterplans being spouted resemble the last days of the Reich, when Hitler was imagining all manner of invisible forces to reverse the anhilation on the ground!! Utterly futile !!

Duncan Reid 29 September, 2021 11:57 am

So CCG’s replaced by ICS’s overseen by HSSIB’s
Well that’s perfect all problems solved
Surely I can’t be the only one who has lost the will to carry on ……TTFN .. Golf course beckons . Knock yourselves out

Kevlar Cardie 29 September, 2021 12:03 pm


terry sullivan 29 September, 2021 12:51 pm

another quango? £266 000 000 000 a year already

and several more in pipeline

David Banner 29 September, 2021 1:10 pm

So patients with a grudge have yet another new stick to beat us with, this time a really big stick with nails in.
Glad that our screams of low morale have been listened to.

Decorum Est 29 September, 2021 2:47 pm

Guess all those tossers need new three, four and even five lettered abbreviated committees, bodies and groups etc, to justify their expensive though worthless existence?

Darren Tymens 29 September, 2021 3:55 pm

MORE regulation? Who thought that was either needed or a good idea?

Patrufini Duffy 29 September, 2021 4:14 pm

Got nothing to do with medicine as usual.
Crack on.

James Weems 1 October, 2021 9:11 am

Oh goody. More regulation.

Iain Hotchkies 1 October, 2021 5:48 pm

As the number of GP WTE bums on seats continues to fall, and the number of doctors and noctors employed in all these non-clinical roles continues to rise, presumably we will get to the point where there are a handful of observers watching every GP in real time via CCTV.

Luckily, and keeping up the thread visible through many comments so far, I’m over 60 now and can get out with three months’ notice.

Lesley Kay 1 October, 2021 5:57 pm

Please read the update. This isn’t a new organisation and it isn’t a regulator. HSSIB will replace HSIB which undertakes patient safety investigations without attribution of blame or liability. You can see our investigations at and you might find our recent investigations into cauda equina syndrome and childhood asthma relevant and interesting. Thank you to Pulse for updating and correcting this article at 5pm today.