Proposed 'safe space' needs further work

MDDUS believes the proposed development of a 'safe space' to protect staff in healthcare safety investigations requires further definition as interventions which are high on rhetoric and low on detailed statutory and implementation planning run the risk of being counter-productive.

The government recently published a consultation outlining a proposal to legally ensure that information that staff provide as part of a health service investigation will be kept confidential except where there is an immediate risk to patient safety, or where the High Court makes an order permitting disclosure. The procedures are intended to "broadly mirror" those followed in air accidents investigations.

The stated aim is to create a balanced 'safe space' and ensure staff that the information they provide will not be passed on. It is also intended to reassure patients and families that they will be given the full facts of their, or their loved ones’, care.

Responding to the government’s consultation Providing a ‘safe space’ in healthcare safety investigations, MDDUS CEO Chris Kenny said: “There is a common interest among government, professionals and indemnifiers in encouraging candour and reducing risk in order to achieve early resolution of individual problems and enable systemic learning. But interventions which are high on rhetoric and low on detailed statutory and implementation planning run a real risk of being positively counter-productive.

"Although we are not opposed in principle to the concept, the proposal put forward in the document needs considerably more definition before it is remotely capable of implementation.

"In particular, in the absence of far tighter tests for the High Court to consider in deciding whether to disclose material and similar transparency in the way regulators choose to interpret their own duties, it is highly likely that the initiative will not carry the necessary degree of professional support which it will need to be seen through into operation.

"We also consider that government should not underestimate the scale of change needed in introducing the concept of a 'Just Culture'. If this is going to be seen as credible, there must be a major change in the way that ministers in future react to individual issues of patient safety and a toning down of the language of punitive accountability. In short, if words about 'Just Culture' are not followed through into action, credibility will be lost."

On the important issue of careful implementation, Kenny added: "It is at least as important to test the practicability of comprehensive implementation as it is to test the principle first in the issue of maternity services.

"This may imply a two-fold approach to piloting before any general rollout of the scheme. That also means continuous ongoing investment in monitoring the effectiveness of the policy and making sure that national guidance from all relevant bodies remains bang up to date in the light of changing practice and legal judgements.

"Again without this commitment to learning from experience and the necessary investment that goes with it, the initiative is bound to fail."