NHS Redress Bill [HL]

Amendment No. 22 would place a specific duty on scheme members to inform a patient when a mistake has been made. I agree that where a mistake is made during a patient’s hospital care and a patient suffers an adverse outcome it is key that the patient is informed, and the intention is that the scheme will provide for patients to be informed in those circumstances. It is intended that the scheme will require scheme members to investigate, where a scheme member identifies a case that may be eligible under the scheme; or where a person applies to the scheme, the scheme member will investigate. Clause 4(2)(f) provides for the notification of the commencement of proceedings under the scheme, and it is intended that in circumstance where a case is identified as being potentially eligible under the scheme—where a mistake has been made—the patient or other person potentially eligible for redress will be informed. After investigation, it is intended that the scheme authority will determine whether the case falls within the scheme. Under Clause 3(2), the Secretary of State is obliged to include in the scheme the giving of explanations, and it is intended that the explanation will identify mistakes that have been made and explain how the harm or loss came about. Amendment No. 28 would enable the scheme to make specific provision about those people who should be informed about proceedings under the scheme. Again, I agree that ensuring patients are kept informed about proceedings under the scheme at every step of the process will be vital to the scheme’s success. The provisions in the Bill are sufficient to achieve that effect; I have already mentioned Clause 4(2)(f). It is envisaged that scheme members will also want to take appropriate steps to ensure that the patient is kept at the heart of the process, including notifying them at an appropriate early stage, keeping them informed of the progress of their case, informing them of the results, and meeting any remedial care needs that they may have. It is envisaged that good practice on keeping the patient informed throughout the process will be set out in guidance issued by the scheme authority, which will be drawn up in consultation with stakeholders. Scheme members will be required to have regard to such guidance under the obligations set out in Clause 10(2)(d). The noble Earl, Lord Howe, raised the issue of the National Patient Safety Agency. One of the key objectives of the scheme is to facilitate learning from mistakes at a local level. The NPSA’s confidential reporting system for adverse incidents has a similar objective; it aims to identify patterns and facilitate learning from mistakes at national level. Certainly in a previous incarnation I was pleased to get that scheme well established with the NPSA. The NHS redress scheme is intended to encourage a move towards a more open culture with an active approach of identifying mistakes and the goal of providing open and full explanations as a matter of course. To achieve that, the Department of Health will be working together with the NPSA and the broader NHS to encourage a more open culture and foster an open team attitude. Clause 13 already imposes a duty on the scheme authority and the NPSA to co-operate with each other where it appears to them that it is appropriate to do so for the efficient and effective discharge of their respective functions. That will further the NPSA’s objective of collecting data at a national level on adverse incidents across the NHS. Reporting of incidents, whether openly or anonymously, is key to gaining knowledge about things that go wrong, learning lessons and providing practical solutions. Amendment No. 54 enables the scheme authority to require scheme members to provide information or documents to the NPSA. As I have said, one of the key objectives of the redress scheme is to facilitate learning from mistakes. The confidential learning system of the reporting system of the NPSA has a similar objective. Clause 13 already imposes a duty of co-operation between the two agencies and we believe that that, together with the arrangements that are already in place for the NHS to report to the NPSA, make further amendment of this legislation unnecessary. Guidance about disclosure to patients will be issued, but it will be open to the Secretary of State to provide in the scheme for patients to be provided with key documents, using powers in Clause 10(2)(b) to require scheme members to carry out specified functions.