New guidelines are to be introduced for doctors, nurses and midwives on the importance of being honest with patients when things go wrong.
Known as a "duty of candour", the guidelines will clarify how every healthcare professional must be open and honest with patients when something goes wrong with their treatment or care.
This means that healthcare professionals must:
- tell the patient when something has gone wrong and to do so at the earliest possible opportunity;
- apologise to the patient, preferably face-to-face with a follow-up in writing. Details of the apology should always be recorded in the patient’s clinical records;
- offer an appropriate remedy or support to put matters right (if possible);
- explain fully to the patient (or carer/family member where appropriate) the short and long term effects of what has happened.
The guidance was drawn up by the General Medical Council and the Nursing and Midwifery Council, and applies to more than 950,000 doctors, nurses and midwives working in the UK.
A link to the guidance can be found here.
The guidance also encourages a learning culture by reporting clinical errors, so that lessons can be learnt quickly. Healthcare organisations should have a policy for reporting adverse incidents and near misses in addition to the various national reporting systems that exist at present.
Additional duties apply to healthcare professionals who have management responsibilities to set an example and encourage openness and honesty in reporting such incidents.
The guidelines flow from the Francis Report into the scandal at Stafford Hospital, in which hundreds of patients suffered poor care and neglect.
Niall Dickson, Chief Executive of the General Medical Council, said that while things can and do go wrong, it is what doctors, nurses and midwives do afterwards that matters. "If they act in good faith, are open about what has happened and offer an apology, this can make a huge difference to the patient and those close to them.
“We also 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 inquiry and from our own work with doctors that such a culture does not always prevail. It remains one of the biggest challenges facing our healthcare system and a major impediment to safe effective care.”
These guidelines supplement the statutory duty of candour on all healthcare providers which came in to force on 1st April 2015. Failure to comply with the statutory guidelines may result in the Care Quality Commission prosecuting such an organisation.
As a clinical negligence lawyer, I strongly welcome any steps that are taken to improve patient care. However, it remains to be seen if healthcare organisations invest the required time and money needed to train their clinicians so as to ensure this new duty of candour makes any real difference.
Ian Cohen is a Senior Clinical Negligence Solicitor at Slater and Gordon Lawyers in Liverpool.
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