The vast majority of investigations in the NHS are conducted internally by the organisations where the incident occurred. This is because staff within those organisations are best placed to understand the unique situation and context that the incident occurred in. However, Investigations will always be undertaken independently, that is to say, by people not involved or connected to an incident. Organisations are required to ensure investigations are open and transparent for both staff and patients/families.
PTR does not require independent investigation from the organisation that is the subject of a complaint. PTR advises that investigations should be undertaken by persons not connected with the incident, and with appropriate investigation training and knowledge. The Regulations also allow independent expert reviews to be commissioned by health bodies in certain circumstances, and involving the complainants in the appointment of any independent expert where needed.
To support independence, the National Nosocomial Review Programme requires organisations to establish local scrutiny panels, which are independent of the investigation. The scrutiny panel has responsibility for ensuring regulatory standards of investigations are met, and will make the final assessment on a case by case basis as to whether care was reasonable. The NHS Wales Delivery Unit will be responsible for assuring the overall standard of investigation and scrutiny panels from a national perspective.