The seven building blocks of independence for healthcare reviews

Independence promotes confidence in matters where judgements are being made. This is particularly when using public funds for independent review work, it is entirely appropriate to want to know that independent reviewers can exercise judgement without fear or favour.

At Niche we have identified there seven important building blocks for independent reviews. These are:

1. Transparency in funding and contract tendering – Any funding could be seen as an inducement for an opinion but it doesn’t follow that zero funding or funding by another route is a more independent alternative. This is the point of competitive frameworks and oversight of procurement.
2. Identifying and managing conflicts of interest – This is not only about where someone has worked in the past, but also about their close personal and professional relationships and any opinions they may have stated.
3. Maintaining suitable boundaries – to maintain independence it is important to maintain a suitable environment where all parties to the investigation feel that there is equity in relationships (with staff and families) and that bias has not crept in.
4. Minimising bias and subjectivity – Recognising and challenging bias amongst reviewers is crucial and this is done through training, awareness and challenge.
5. Checks and balances: Providing judgements based upon solid evidence is the biggest safeguard of independence. Evidence must be triangulated, for example, by combining interview feedback, survey data, documentation and audit information to provide a rounded view.
6. Validation and accountability: No reports should ever be finalised without proper factual accuracy checking having taken place. This includes offering a right of reply on all reports, and Maxwellisation¹ on public reports.
7. The end product: Being particularly critical in a report should not be the only defining factor of its independence – but, if there has clearly been a balanced view applied to the review findings, this should be a reasonable indication that independence has been applied. In short, the end report should speak for itself.

If you would like to learn more about how independent investigations can help you organisation fill in our contact form here.