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Plan to combine NHS regulators and safety in single 'new body'

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Many of the functions of Monitor and the NHS Trust Development Authority are expected to be brought together in a single ‘new body’, which would also take on new patient safety and improvement work, LGC’s sister title HSJ has been told.

  • TDA and Monitor functions expected to join in single “new body”
  • Jeremy Hunt to announce it will also host air accident style investigation branch
  • “New body” to take on patient safety and improvement


The Department of Health announced last month that from later this year the two regulators would share a single chief executive. At the time it said that the organisations would be “working closely together”.

However, HSJ understands the DH and other national officials are now working on plans to create what several senior sources said is a “new body”. It would bring together most of the TDA’s functions, and Monitor’s foundation trust regulation and development work. It would oversee all trusts and FTs.

Jeremy Hunt 2014

Jeremy Hunt is due to make an announcement on the move next week

It is currently unclear whether it will be a new and separate statutory organisation to the current Monitor and TDA, or work through the existing structures.

The main functions remaining outside the “new body” would be Monitor’s economic and competition regulation.

HSJ has been told health secretary Jeremy Hunt is due to make an announcement referring to the move next week, and to say that the body will also host a new patient safety Air Accident Investigation Branch style function for the NHS. This was proposed by the Kirkup inquiry into failings at Morecambe Bay, and by the public administration select committee earlier this year.

National patient safety functions currently hosted by NHS England, such as the National Reporting and Learning System, will also be transferred to the new regulatory body. It would therefore bring together financial, governance and performance regulation of all NHS providers with safety and improvement functions.

Senior sources involved in the discussions said the new incident investigation arm would be operationally independent of the new regulator to protect trust and confidence in it. A panel of patient safety experts is to be established following Mr Hunt’s announcement next week to examine how it should operate and how to ensure independence.

Those involved hope it will help trusts improve their own incident investigations to a consistent standard, as well as enable trusts to request specific help. In what are expected to be rare cases, it will have the power to launch its own inquiries into clinical incidents to determine what happened and provide learning for the future.

Although it will have regard to concerns of patients and families, the investigation body will not consider patient complaints or seek to establish blame.

HSJ understands the DH and other national officials are working on the details of the changes to the regulators and the patient safety functions, and how they will be achieved organisationally and legislatively. It had been expected there would be no legislation to join the two regulators. However, legal change would be necessary to move NHS England’s safety functions.

One source close to the process said: “Any new investigatory body needs to be independent. Practically it has to sit somewhere and have reporting lines and be accountable to someone, but operationally it has be independent, as was recommended by [Public Administration Select Committee], in order to have trust across the system and the trust of patients.”

The source added: “I would support legislation to establish the body; it needs to be given a long term future so that patients and staff know it is not going to go away.”

The DH was approached for comment.

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