HSIB's patient safety investigations are now handled by HSSIB and MNSI

Former healthcare watchdog, HSIB, has now handed over its patient safety investigations programmes to HSSIB and MNSI. HSIB’s transformation to HSSIB finally took effect on 1st October 2023.

This means that HSIB’s national investigations programme will now be carried out by HSIB’s successor, HSSIB, with enhanced powers which include access to patients’ records and other information without prior consent, compulsory participation by healthcare organisations and staff, and the controversial use of ‘protected disclosure’ also known as 'safe space'.

HSIB’s former maternity investigations programme will now be carried out by MNSI, the Maternity and Newborn Safety Investigations programme.

What is HSSIB?

HSSIB is the Health Services Safety Investigations Body, which came into operation on 1st October 2023. HSSIB was created as a result of the changes made by the Health and Care Act 2022 to give independent, statutory status to what was previously known as the HSIB.

HSSIB has taken over the national investigations programme that was previously carried out by HSIB. HSSIB will continue to investigate patient safety concerns across England with the aim of improving NHS care, by sharing what it learns from patient safety incidents at a national level. These investigations focus on understanding why patients have been harmed or may be at risk of harm, looking at how the healthcare system can improve, rather than attributing blame to specific individuals or organisations. HSSIB continues the work of the HSIB’s national investigations programme but the Health and Care Act increased HSSIB’s power, so its patient safety investigations will be carried out in a different way.

HSSIB has enhanced powers to compel people and organisations to cooperate with their patient safety investigations. They have the right to enter premises, such as hospitals, and seize or inspect documents, equipment, patients’ medical records or other evidence that may be relevant to their patient safety investigations.

HSSIB also has the power to prevent disclosure of information, such as statements or interviews from healthcare staff or patients, even for the purposes of medical negligence court cases, coroners’ inquests or PHSO investigations. HSSIB believes that ‘safe space’ protection will encourage healthcare staff to be more open and honest in sharing their evidence of healthcare incidents with HSSIB’s investigators, but the secretive process has been widely criticised for its potential to increase the distrust felt by patients who are seeking answers after they have been harmed by mistakes in their medical care.

Previous Parliamentary committees have acknowledged that HSSIB’s safe space procedure is not suitable for maternity safety incidents. The Health and Care Act made no provision for HSSIB to carry out maternity investigations but, as of 1st October 2023, these highly specialised and sensitive investigations will be carried out by the newly formed Maternity and Newborn Safety Investigations programme, also known as MNSI.

What is MNSI?

The former HSIB’s maternity investigations programme has now become the Maternity and Newborn Safety Investigations programme or MNSI.

Unlike HSSIB, MNSI does not have statutory independent status but is now hosted by England’s health and social care regulator, the Care Quality Commission (CQC), which is sponsored by the Department of Health and Social Care (DHSC)  and works closely with the NHS.

The Maternity and Newborn Safety Investigations (MNSI) programme is part of the government’s national strategy to improve maternity safety across the NHS in England.

All NHS trusts which provide maternity care are required to report maternity safety incidents to MNSI if they involve babies born at term (after 37 weeks of pregnancy) where:

• the baby dies during labour and before birth (intrapartum stillbirth);
• the baby is born alive but dies in the first week of life (early neonatal death);
• the baby suffers a severe brain injury which is diagnosed in the first 7 days of life.

MNSI also investigates maternal deaths where a mother dies during pregnancy or within 6 weeks after the pregnancy ends.

In addition to individual patients’ maternity safety incidents, MNSI identifies and reports on recurring themes from these investigations to help the NHS learn and improve maternity care across the healthcare system. As with the former HSIB’s maternity investigations, MNSI does not blame individual healthcare staff when investigating maternity safety failings.

Unlike HSSIB, MNSI is required to seek the patient’s (or in the case of a baby, their parents’) consent to access the patient’s medical records for the purposes of their investigation. Families can choose whether or not to consent, or participate in MNSI’s investigation of their maternity safety incident.

Families should be aware that when MNSI has completed their investigation, MNSI reports their findings to NHS Resolution, whose legal defence team then prepare to respond or defend any potential claim for compensation under the Early Notification Scheme. We strongly advise families whose maternity care has resulted in a brain injury to their baby or severe harm to the mother to seek independent, legal advice from solicitors who specialise in helping families with birth injury compensation claims. Your child may be entitled to substantial compensation.

If you or your partner or child have suffered severe injury as a result of medical negligence or have been contacted by HSIB/HSSIB/MNSI/CQC or NHS Resolution, you can talk to a solicitor, free and confidentially, for advice about how to respond or make a claim by contacting us.