Good afternoon and welcome to my latest patient safety update. This week we take a close look at safety related amendments to the Health and Social Care Bill; the emotional House of Commons debate to mark Baby Loss Awareness Week; and of course, where we are on COVID. As ever here’s the link to sign up if you have not done so

COVID LATEST The most recent ONS survey sees a fall in the number of community cases for England which is now 620,000 people, or 1 in 90, with the virus. This is down from 1 in 80 for the previous week. The government dashboard for the last seven days however, has new cases moving in the wrong direction again with a rise of 12% - but admissions and deaths are going down both on the dashboard and the latest ONS death certificate figures. Grounds for cautious optimism that the September school spike has not triggered the exponential growth we saw this time last year. But just in case the government is now seeking views on their plans for vaccine passports.

INQUIRY The Prime Minister met with the COVID Bereaved Families for Justice yesterday and it looks like a chair of the public inquiry will be announced before Christmas. If you can’t wait for this inquiry to start then the joint science and technology/health and social care committee report into the government’s handling of the pandemic will be published imminently so watch this space after the conference season is over.

HSIB AND THE HEALTH AND CARE BILL As many of you will know the Health and Social Care Bill that is currently going through the House of Commons will put HSIB onto a statutory footing. HSIB is the no-blame independent investigator modelled on the Air Accident Investigation Bureau system that many credit with transforming a blame culture to a learning culture inside airlines (and in 2017 there were zero passenger deaths worldwide, quite an achievement). It is great that the new body is being put on a statutory footing but we need to make sure it works so I have put my name to some amendments that clearly define what material is protected, remove the ability of coroners to require the publication of such protected material and remove the power for the Secretary of State to authorise the disclosure of materials for reasons other than those in the Bill. For those who are interested these are amendments 86 to 91 tabled on a cross-party basis by my SNP colleague Philippa Whitford. We basically want to give those participating in HSIB investigations the same assurances about confidentiality that exist in the airline industry so that investigations can happen fast and without people worrying their career may be affected if they tell the investigators exactly what happened.

WORKFORCE (AGAIN) There can be no safe care without safe levels of staffing - and the Health and Care Bill is a big chance to sort this out. For those following my long running battle to get this sorted it is worth checking out the debate that took place in the Committee on clause 33 of this Bill. My colleague Chris Skidmore tabled an excellent amendment that would overhaul workforce planning by requiring independent projections of workforce requirements over the next 5, 10 and 20 years to be published every 2 years. The amendment was drawn up with the support of many of the Royal Colleges, think tanks, and charities working in the sector and so it was disappointing that Ed, who I rate as a minister, didn’t really deal with the issues at stake. It currently feels like it is Treasury resistance to reform that is stopping this going through but getting the right number of staff in place is the single most important barrier to safe care at the moment - and on the off chance anyone from HMT is reading this email is also much cheaper as it will reduce the ridiculous £6 bn (you read that right) we currently spend annually on locum and agency staff. We will return to this amendment in later stages I have no doubt.

BABY LOSS DEBATE Some amazingly powerful speeches were given last week in the House of Commons debate to mark (early) the annual Baby Loss Awareness Week. I would highlight my fellow co-chair of the APPG on Baby Loss, Cherilyn Mackrory’s speech, but there were many brilliant contributions. You can see my speech in two parts (here and here) where I focused on the Select Committee’s calls for radical reform of the compensation system so that we encourage learning not blaming when something goes wrong. I also mention the loss of my own baby sister Sarah at 6 months which I cannot remember (I was two) but affected my parents very badly.

WHAT’S IN A NAME? 'Patient safety’ started as a euphemism for medical error but has come to mean more (safe staffing for example which is ultimately down to the government) - the trouble is it is not a phrase with cut through to the public. On the other hand it is getting real traction inside the world of medicine so on balance I think we should stick with it but do email your thoughts…

Jeremy Hunt