Health and Care Bill (Second sitting)

Jo Gideon Excerpts

Committee stage
Tuesday 7th September 2021 Public Bill Committees

[The Chair]

We will now hear from Ian Trenholm, the chief executive of the Care Quality Commission, and Keith Conradi, the chief investigator at the Healthcare Safety Investigation Branch, both of whom are appearing in person. We have until 4 o’clock for this session. May I ask you both to introduce yourselves for the record?

Ian Trenholm: Good afternoon. My name is Ian Trenholm and I am the chief executive of the Care Quality Commission.

Keith Conradi: I am Keith Conradi, the chief investigator for the Healthcare Safety Investigation Branch.

[Jo Gideon (Stoke-on-Trent Central) (Con)]

Q Thank you for attending. Can you characterise the contribution this Bill will make, in your opinion, to patient safety and quality of care?

Ian Trenholm: The Bill will add value to patients in a number of different ways. There are four areas that we have particular interest in. The first is around the work we expect the Government to ask us to do on oversight of the individual ICSs. Building on the comments that have just been made, our contributing to the assurance around ICSs will be an important part of how we can add value. We will do that by drawing to the attention of local communities both the good work that is going on in a particular place, and areas where there are some challenges. We will also be able to look across the country, demonstrate where things are going well and help with improvement, as we do with the regulation of individual providers.

The Bill also contains a provision for us to provide assurance regarding the way local authorities discharge their Care Act 2014 duties. Again, that gives local people the certainty that local authorities are discharging their responsibilities. If you bring those two things together and connect local authority duties around the Care Act and social care with what is going on in healthcare, you get a whole-system view, and we are able to give an independent overview of that, which we report to Parliament and the public.

There is also a provision in the Bill relating to food standards in hospital. It is well known that people’s recovery is aided by good-quality hydration and nutrition that is appropriate for the social and cultural needs of that particular place. As part of our work, we will be asked to look at that.

Finally, building on the comments Mr Madden made a couple of witnesses ago, the miscellaneous provisions within the Bill on data sharing and the requirement to co-operate are also powerful and enable us to do our job as an intelligence-driven regulator. From the point of view of reducing bureaucracy, they mean that we collect data once and then we can share it among the many partners involved in regulating different parts of the health and care system. Those are four particular points where I think the public would see value in the work we do.

Keith Conradi: From our perspective at the Healthcare Safety Investigation Branch, we welcome the introduction of this part of the legislation. We have been working in shadow form for the past five years, without any real powers, and the things we have missed there are likely to be introduced in the Bill, such as power of entry, so that we can access people quickly in an investigation. Any investigator will tell you that the quality of the investigation evidence, particularly interviews, degrades quickly over time, so the ability to go in quickly is hugely important. Also, not being able to access data that we know people hold has been quite frustrating in our current guise. We have sometimes had to wait for months and months for data in order to be able to complete an investigation.

The other thing that we are particularly keen on is being able to properly protect information that people give us in a protected environment, so that we can ask them to be as candid as possible with their experiences. We want to be able to protect that information from being released more publicly.

[Jo Gideon]

Can I ask just one more question, Chair?

[The Chair]

I am not being flooded with a whole array of hands, so why not? On you go. I will come to you in a second, Edward.

[Jo Gideon]

Q I just want to come back on the hospital food standards. I know that malnutrition is an issue that has been raised within the hospital setting. Would you be able to set parameters for what the reporting requirement is in order to measure standards in that regard, for instance?

Ian Trenholm: We will be inspecting against the hospital food standards—is that what you mean? We are not going to be setting individual nutritional standards; we will be inspecting against the NHS’s food standards. We are going to deliberately make sure that our work does not overlap with organisations such as the Food Standards Agency, for example. To be very specific about it, we are not going to be inspecting vending machines or taste-testing food in canteens. What we are going to be doing is looking at the hydration and nutrition strategies that, say, a board in a hospital has set for its particular area. As we go around the hospital, we will be looking at whether that strategy is being enacted for the cultural and social needs, in particular, of the people in that hospital. Does that answer the question?

[Jo Gideon]

Yes. Well, it was more from a medical point of view than from a vending machine point of view. That is absolutely helpful. Thank you.

[The Chair]

Do you have anything to add to that, Mr Conradi?

Keith Conradi: I think that is outside the HSIB’s experience.