Health Bill (First sitting)

Sureena Brackenridge Excerpts

Tuesday 16th June 2026 Public Bill Committees

[Sureena Brackenridge (Wolverhampton North East) (Lab)]

Q On that point, Dr Dash, what would you say to concerns that have been raised with me by Healthwatch Wolverhampton that patients and service users will be reluctant to raise concerns from within the system? How will your recommendations help with that?

Dr Dash: I think that we do need to recognise that. I hear that as well and experience it myself; lots of people are often reluctant to come forward, and they think, “If this is my GP, how is this information going to be treated?” That is why we need to really raise the calibre of our directors of patient experience. There are ways in which you can manage that and treat that data confidentially—in fact, you have to treat all data confidentially. There are ways in which you can support people and give them the confidence that their information will be taken seriously and treated confidentially. You can do that often through focus groups, one-to-one conversations and anonymous surveys. We are hoping to be able to do a lot more of that through the app, to link it directly to people’s care, and to give people prompts as soon as they have had an interaction: “Please feed back.” I think there are ways in which we can overcome that. Bringing this much closer to people’s care, linking it in much more to day-to-day practice and making sure that feedback goes straight back to our frontline clinicians in an anonymised way to encourage and support them to improve brings a significant benefit, and we can find a way around the concerns about confidentiality.

[Gregory Stafford (Farnham and Bordon) (Con)]

Q I should declare that I am a member of the all-party parliamentary group on patient safety. Apologies, Dr Dash, I have questioned you on this many times, but I am going to continue to do so. When the King’s Fund, the Nuffield Trust and the Health Foundation were in front of the Health and Social Care Committee and they talked about bringing HSSIB into the CQC, all three of them said very clearly: “Don’t do it.”. In fact, I can find almost nobody apart from you and the Department who thinks that moving HSSIB into the CQC is a good idea. Does that give you any pause for thought about whether you are recommending the right thing?

More specifically, if, as you said to the Health and Social Care Committee, the safe space element would be retained and HSSIB would operate as an independent organisation, how can you square the fact that it would remain independent and yet be part of the CQC? If it does remain independent, what is the need to bring it into the CQC?

Dr Dash: The point of bringing it into the CQC, as I said before, is that we are trying to simplify this landscape. There are so many different organisations continually commenting and doing reviews—often replicating the same reviews that other people have done. The concern is that it is distracting rather than enabling. The hope that I had when I made the recommendation, and still have now, is that by bringing HSSIB into the CQC, you can align the work of the two.

For example, if the CQC is going round the country and spotting a particular problem with the way in which anaesthesia is being given or with managing patients post-surgery, the CQC could then say to HSSIB—that team of people with specific expertise—“Can you go in and take a look at this? Can you do a detailed focus review of this particular area of care that we are spotting through our visits and which seems to be a particular challenge?” It is that bit about enabling the CQC to identify a problem and then asking HSSIB to review it in detail, and HSSIB bringing its expertise in investigations into the CQC to enable the CQC to go deeper and then come back to the NHS with particular areas, but also to supplement the work of the NHS.

I would like to point out that since HSSIB was established, the NHS has established its own much more rigorous, much more robust investigatory teams and processes. Of course, I am not saying that they are perfect—we can all see that—but I encourage all colleagues here today to look at the work they are doing, the specific areas they are reviewing, the outputs of those reviews and the ways in which those are leading to improving care. That feels to me to be a much more systematic way of addressing the concerns of patients, families and staff in the place where those concerns happen, having mechanisms to escalate those through the NHS so you can bring them to regions—some investigations get done at the NHS England level—and having the CQC as an independent body that can separately review and spot if there are problems but also ensure that those investigations within the NHS are happening well.

--- Later in debate ---

[Joe Robertson]

Q If responsibility for managing and safeguarding the single patient record is to sit with general practice, if that is what the Government want, can you tell us, Kay Keane, as chair of the Institute of General Practice Management, what the implication would be for workload, and particularly workforce, in practice management?

Kay Keane: I think it is impossible, really, for me to understand that. It is a large part of our job already. As Dr Dickson said, we act as a small business. We do all the things that any other small business does, so being able to manage that record on top of that would take a huge amount of investment into general practice.

I would argue that maybe the investment into general practice should not be on data, but should be in the wider workforce. We are really good at looking after our data now. We care about it, we hold it close to the care of the patient and we share it only when appropriate, but in our view to then be the data controller of other information is too much and is unmanageable for a general practice to do.

Equally, our data is very personal to us, and we want to keep hold of that. We do not want our patients worrying about the stories that they tell us, so a model where we feed into something else and have responsibility for the bit that it is fed into sits more comfortably with the Institute of General Practice Management.

Dr Dickson: I do not have much to add to that. The devil is in the detail of where it sits and how we reassure patients that we are trusted with their data—that we are sharing what they have given us appropriately for their health, but not for spurious reasons. I think people’s understanding is that we share an awful lot more than we do, so there is a gap. People perceive that we are going to overshare, whereas actually this will allow us to come up to the level that we should be at.

[Sureena Brackenridge]

Q My question is to Dr Dickson and is about education and training policy, responsibility for which will be transferred from NHS England to the Secretary of State. I know that you have a lot of interest in medical training and education, so what do you feel would be the impact?

Dr Dickson: I think the impact could be really positive. At the moment, we train nationally to high standards, so that the product of medical education can be deployed anywhere in the UK, and we are also all trained to develop, innovate, change the service and move forward. What we miss at the moment is parity of esteem for education as a productivity function of the NHS. There is the productivity function of elective care, waiting times, cancer treatment and all those things, but education must sit at that level of esteem for productivity for all professions in order for the service to continue—not to innovate, change and develop, but just to continue. Moving things to the Secretary of State gives us a chance to ensure that that pure parity is seen. The danger is that if you move the function in, it gets lost in the service productivity sphere. There is a huge opportunity to firmly embed the education and strategic development of different roles as a true productivity function of the NHS, which it needs to be.

[The Chair]

We have come in under time for a change. Thank you both very much indeed for joining us. Your contribution is invaluable.

Examination of Witness

Dr Rosie Benneyworth gave evidence.

--- Later in debate ---

[Helen Morgan]

Q What could be changed in this legislation to ensure that HSSIB can retain trust and independence from the regulatory body?

Dr Benneyworth: There needs to be much more clarity about governance and how that will work in the legislation to protect independence. There are potential compromises that could happen, such as a Healthwatch-style model that has its own independent leadership within the CQC, its own governance arrangements and, importantly, its own identity. That would enable it to keep its independence, while being part of a larger organisation. In the legislation, it is vital that there is a legal duty for the CQC to protect safe space.

[Sureena Brackenridge]

Q I feel that my question may have just been answered, but you may wish to add something, Dr Benneyworth. Will patient safety accountability be improved when a patient’s care spans different organisations within an ICB?

Dr Benneyworth: One of the things that we see regularly in our investigations is that people fall down the gaps between organisations. We have the ability to look right across the system and understand a person’s journey. As a recent example, we looked at medication errors on discharge from hospital. There are a lot of medication errors, and we looked at the process of how information was being shared and what was happening. Those are the type of things where we see a lot of concerns about patient safety. There needs to be much more clarity about accountability for patient safety.

No one is accountable for the discharge of a patient. There is not one person—no single individual—who is accountable when someone is discharged from hospital to social care. You go through multiple layers of accountability. We are keen to learn from other industries that have effective safety management systems. Part of those safety management systems is having much more clarity about accountability, which is lacking across the NHS. I very much hope that, with the changes to ICBs, they really do think about accountability for patient safety.

[Edward Argar (Melton and Syston) (Con)]

Q In her evidence earlier, Dr Dash said that one of the reasons for her recommendations in her second review of changes to the regulatory and investigatory landscape is that it is a problem for the provider landscape that there are so many different organisations making so many recommendations. You have just said that HSSIB makes very few recommendations. Will the merging or folding—however you wish to characterise it—of HSSIB into the CQC lead to any meaningful reduction in the number of recommendations that organisations have to cope with?

Dr Benneyworth: No, we do not make recommendations to provider organisations at all. All our recommendations go to national organisations. I completely agree with Dr Dash that there are too many recommendations. In fact, HSSIB raised that concern through our work two years ago and flagged it to Dr Dash. We wrote a report called “Recommendations but no action”. We are very concerned about the plethora of recommendations going to providers, which create a huge amount of noise but, distressingly for the families involved, do not lead to the changes needed.

I completely agree that there are far too many recommendations. I am leading some work to address that—we are setting up a recommendations hub with the Department of Health and Social Care—but we are not that problem. We have made 39 recommendations since investigations launched and HSSIB started three years ago, and they are all to national bodies. We might reduce the burden on national bodies by taking that away, but it will not have any impact on providers.