The Duty of Candour

The Duty of Candour was introduced in November 2014 for hospitals in England, and four months later it was extended to all healthcare bodies registered with CQC. It has never been entirely clear what the statutory duty of candour would achieve that the existing professional duty would not. The difference is that the threshold of harm requiring action by healthcare bodies in the statutory duty is higher than the professional duty.

An area of difficulty may be deciding whether an incident reaches the threshold for notification under the statutory duty. This may be confusing, as the threshold is low for the doctor’s ethical duty (any harm or distress caused to the patient) while the thresholds for the contractual and statutory duties are higher and includes “prolonged psychological harm”.

When something goes wrong during medical care, the worst possible reaction of professionals such as doctors, nurses and midwives is to try and cover up their mistakes.  A simple “Sorry” must be extended to the patient, friends and family, this is obviously just the right thing to do!  It fosters mutual trust and respect which forms the basis for good care. The real challenge is creating the right culture in healthcare organisations where candour is accepted as the norm and this will not happen overnight!

In any patient safety incident, regardless of cause, fault, or blame, the individual harmed would expect and appreciate an explanation and an apology coupled with transparency. The apology is an acknowledgement of what has happened—it brings things out into the open. It’s also the first step in a process of reconciliation. Get the first step wrong and you will struggle to maintain the trust of the patients and their relatives.

BPP University School of Health offers Onsite and Online Live Classroom sessions on the Duty of Candour to help gain confidence and clarity on this new statutory duty and drive the required culture change to banish the fear of saying “Sorry”.

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