Establish a Hospital Incident Investigation Branch (HIIB) to Improve Patient Safety

Nineteen-nurses are calling on the government to make our NHS safe again.

We call on the government to establish an independent Hospital Incident Investigation Branch (HIIB), modelled on the proven approaches of the Air Accidents Investigation Branch (AAIB) and the Rail Accident Investigation Branch (RAIB).

An HIIB would investigate serious patient-safety incidents, systemic failures, and near-misses across hospitals. Its purpose would be learning, not blame: finding root causes, making national recommendations, and preventing recurrence. This is how aviation and rail have made travel safer—by investigating independently, sharing findings openly, and turning lessons into action.

Why this matters:

·        Independent, learning-focused investigations save lives. An HIIB would identify systemic risks—staffing models, handover processes, equipment reliability, digital systems, and safety culture—so fixes address causes, not just symptoms.

·        Consistent national standards. Hospitals currently vary in how incidents are reviewed. A central, expert body sets methods, definitions, and expectations so patients receive the same safety protections everywhere.

·        Faster, clearer learning from harm and near-misses. Near-miss reporting is a cornerstone of safety in other high-risk sectors. An HIIB would capture and spread insights quickly before harm occurs.

·        Transparency and public confidence. Published reports and recommendations, free from local conflicts of interest, build trust and ensure accountability for implementing safety improvements.

·        Support for staff and families. A just, independent process reduces fear of blame, encourages open reporting, and provides clear communication and support to those affected.

·        Better value for money. Preventing repeat incidents reduces avoidable costs—extended hospital stays, litigation, and disrupted services—freeing resources for frontline care.

Core features of the HIIB:

·        Statutory independence from providers, regulators, and government departments.

·        A learning—not liability—remit, with legal protections that encourage candid evidence.

·        Multidisciplinary investigators (clinical, human factors, engineering, data science, and systems safety).

·        Authority to investigate serious harm and selected near-misses, and to issue timely safety recommendations.

·        Public reporting with clear timelines, data standards, and follow-up on implementation.

What we are asking Parliament to do:

·        Create the Hospital Incident Investigation Branch in law with guaranteed independence and funding.

·        Give it the powers and protections needed to access information, secure evidence, and publish findings.

·        Require health bodies to consider and respond to HIIB recommendations within set timeframes.

·        Establish a national dashboard to track recommendation adoption and impact on patient safety.

Aviation and rail safety improved dramatically when we separated learning from blame and empowered expert, independent investigators. Patients and NHS staff deserve the same. Establishing an HIIB is a practical, evidence-informed step to make hospitals safer, strengthen trust, and ensure that when things go wrong, something better comes from it. We urge the government to act now.

We need to make our NHS safe again for both patients and staff  - take investigations away from Hospital trusts and establish an independent body. Hospital Incident Investigation Branch.