The NMC and GMC have today released new guidance on the professional duty of candour. “Openness and honesty when things go wrong: the professional duty of candour” sets out the standards expected of doctors, nurses and midwives in the UK. The guidance is also intended to help patients understand what to expect from healthcare professionals. By producing joint guidance the GMC and NMC ensure that doctors, nurses and midwives will be working together towards a common professional standard.
The need for individual professionals and healthcare organisations to provide an open and honest working environment to support the reporting of incidents and learning from mistakes is highlighted.
The guidance is divided into two parts – 1) the duty to be open and honest with patients; and 2) the duty to be open and honest with the healthcare organisation to encourage a learning culture by reporting errors.
Openness and honesty with patients
There is emphasis on the importance of apologising to patients when things go wrong. An apology will not be treated as an admission of legal liability and could be treated by a fitness to practise panel as evidence of insight.
The guidance includes advice on the importance of discussing risks with patients prior to treatment; when to speak to patients and what to say; speaking to those close to the patient; and being open and honest about “near misses”.
Openness and honesty with the healthcare organisation
The importance of early reporting when something goes wrong with patient care is emphasised, to enable lessons to be learned quickly and to protect patients from harm in the future.
The details of a number of reporting systems and schemes around the UK are included, as is the importance of healthcare organisation policies and systems for reporting adverse incidents. The guidance provides that individuals should not try to prevent colleagues or former colleagues from speaking out about patient safety. Fitness to practise panels would be likely to consider more serious sanctions if there is evidence of a failure to raise a concern or of an attempt to cover up.
There is also advice on the additional duties for doctors, nurses and midwives with management responsibilities and for senior or high-profile clinicians.
The intended outcomes of adverse incident reporting are set out:
- Lessons are learnt from analysing adverse incidents and near misses
- Lessons are shared with the healthcare team
- Concrete action follows on from learning
- Practice is charges where needed.
This guidance comes at a time when the duty of candour and raising concerns is very much a hot topic. Changes implemented in the wake of the Francis Inquiry into the failings at Mid-Staffs, in particular the creation of a statutory duty of candour, have only recently come into force with universal application. BLM envisage further safeguards and mechanisms to support the raising of concerns will be implemented in the near future, following Sir Robert Francis’s Freedom to Speak Up review and the GMC’s recent consultation on Freedom to Speak Up Guardians.
BLM would be happy to provide training, advice on steps to be taken and the drafting of policies, template notifications and general procedures relating to the implementation of the duty of candour.
Please contact a member of the team for further information.
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