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29.06.15

New 'duty of candour' guidance published for NHS staff

New guidance for doctors, nurses and midwives across the UK on being open and honest with patients when things go wrong have been published. 

Jointly developed by the General Medical Council (GMC) and the Nursing and Midwifery Council (NMC), the ‘professional duty of candour’ guidance sets out the standards expected of healthcare professionals, including “saying sorry”. 

Under the new guidance, doctors, nurses and midwives should: 

  • Speak to a patient, or those close to them, as soon as possible after they realise something has gone wrong with their care.
  • Apologise to the patient – explain what happened, what can be done if they have suffered harm and what will be done to prevent someone else being harmed in the future.
  • Use their professional judgement about whether to inform patients about near misses – incidents which have the potential to result in harm but do not.
  • Report errors at an early stage so that lessons can be learned quickly, and patients are protected from harm in the future.
  • Not try to prevent colleagues or former colleagues from raising concerns about patient safety. Managers must make sure that if people do raise concerns they are protected from unfair criticism, detriment or dismissal. 

In England the professional duty of candour will sit alongside a legal obligation on organisations, with similar measures being introduced in Scotland, Wales and Northern Ireland. 

Jackie Smith, CEO of the Nursing and Midwifery Council, said: “We developed this joint guidance to help nurses, midwives and doctors to uphold a common duty of candour that is set out in their professional standards. They often work as part of a team and that should absolutely be our approach as regulators to ensure we are protecting the public. 

“We believe that the public’s health is best protected when the healthcare professionals who look after them work in an environment that openly supports them to speak to patients or those who care for them, when things have gone wrong. We can’t stop mistakes from happening entirely and we recognise that sometimes things go wrong. The test is how individuals and organisations respond to those instances, and the culture they build as a result.” 

The guidance follows Sir Robert Francis QC’s call for a more open and transparent culture following the failures in patient care at Mid Staffordshire NHS Foundation Trust. 

Niall Dickson, CEO of the GMC, added that the organisations want to send out a clear message to employers and clinical leaders – none of this will work without an open and honest learning culture, in which staff feel empowered to admit mistakes and raise concerns. 

“We know from the Mid Staffordshire enquiry and from our own work with doctors that such a culture does not always prevail,” he said. “It remains one of the biggest challenges facing our healthcare system and a major impediment to safe, effective care.” 

Tell us what you think – have your say below or email opinion@nationalhealthexecutive.com

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