Patients should be told when mistakes are made, senior doctors say Royal College of Surgeons and NHS trust chief executive report to put pressure on Jeremy Hunt over full duty of candour.
All patients should have a right to be told when mistakes are made in their care, even if they do not suffer serious harm, according to a report by senior doctors.
The conclusions of a report by the president of the Royal College of Surgeons (RCS) and an NHS trust chief executive will put pressure on the health secretary, Jeremy Hunt, to agree to a full duty of candour, which patients' organisations have been demanding for some years.
"When things do go wrong, patients and their families expect three things: to be told honestly what happened, what can be done to deal with any harm caused, and to know what will be done to prevent a recurrence to someone else. Health and care organisations have a responsibility to ensure that all of these are reliably undertaken," says the report from Professor Norman Williams of the RCS and Sir David Dalton, the chief executive of Salford Royal hospital.
The Francis report into failures at the Mid-Staffordshire NHS trust called for a duty of candour, which the health secretary supported, but implied it would be restricted to the most serious cases, where somebody dies as a result of poor care.
Williams and Dalton were asked by Hunt to look at where the threshold for candour should be set and what incentives might be needed for hospitals, GP surgeries and other organisations to comply.
They say that healthcare staff should be honest and open with patients and families in all cases where the level of harm is not considered to be "low". There are too many definitions, they say, and they would like to see them brought into alignment, but in their view, there should be a statutory duty on NHS organisations to tell patients what has happened in cases classified by the Care Quality Commission as "moderate" or "severe", as well as those where the patient dies.
"Candour is essential for patients and their families. It is the responsibility of professionals, care organisations and the national bodies that support them to ensure that they have in place, and can sustain, a culture of candour," says the report.
The patient safety charity Action against Medical Accidents, which has led the fight for a statutory duty of candour, was delighted and said that Hunt must accept the recommendations.
"All patients welcome the outcome of the review. It is unthinkable that the government will ignore this recommendation," said its chief executive, Peter Walsh.
"A full duty of candour would probably be the biggest advance in patients' rights and patient safety since the creation of the NHS. For decades, the NHS has frowned upon cover-ups but has been prepared to tolerate them. This will be an end to that."
The Royal College of Nursing backed the recommendation for candour in all cases of significant harm. "We have long felt that in many organisations there is still a culture of blame, fear and secrecy that makes it very hard for staff to admit when things have gone wrong and to learn from mistakes," said Dr Peter Carter, chief executive.
"As the review makes clear, a 'just culture' recognises that mistakes are usually caused by failures in systems or genuine human errors. This review is therefore absolutely right to see the duty of candour in the context of a wider commitment to patient safety, learning and improvements in care.
"Healthcare staff want to provide the best possible care to patients, and work hard to achieve this," he added. "However, healthcare is inherently risky and sometimes things will go wrong. When this happens, patients deserve an open and honest discussion with staff, and to know that lessons will be learned. This can only happen if staff are open with patients, in advance of care, about risks and the potential for harm, and the culture supports 'good conversations' and genuine partnership with patients in their care." The Guardian
All patients should have a right to be told when mistakes are made in their care, even if they do not suffer serious harm, according to a report by senior doctors.
The conclusions of a report by the president of the Royal College of Surgeons (RCS) and an NHS trust chief executive will put pressure on the health secretary, Jeremy Hunt, to agree to a full duty of candour, which patients' organisations have been demanding for some years.
"When things do go wrong, patients and their families expect three things: to be told honestly what happened, what can be done to deal with any harm caused, and to know what will be done to prevent a recurrence to someone else. Health and care organisations have a responsibility to ensure that all of these are reliably undertaken," says the report from Professor Norman Williams of the RCS and Sir David Dalton, the chief executive of Salford Royal hospital.
The Francis report into failures at the Mid-Staffordshire NHS trust called for a duty of candour, which the health secretary supported, but implied it would be restricted to the most serious cases, where somebody dies as a result of poor care.
Williams and Dalton were asked by Hunt to look at where the threshold for candour should be set and what incentives might be needed for hospitals, GP surgeries and other organisations to comply.
They say that healthcare staff should be honest and open with patients and families in all cases where the level of harm is not considered to be "low". There are too many definitions, they say, and they would like to see them brought into alignment, but in their view, there should be a statutory duty on NHS organisations to tell patients what has happened in cases classified by the Care Quality Commission as "moderate" or "severe", as well as those where the patient dies.
"Candour is essential for patients and their families. It is the responsibility of professionals, care organisations and the national bodies that support them to ensure that they have in place, and can sustain, a culture of candour," says the report.
The patient safety charity Action against Medical Accidents, which has led the fight for a statutory duty of candour, was delighted and said that Hunt must accept the recommendations.
"All patients welcome the outcome of the review. It is unthinkable that the government will ignore this recommendation," said its chief executive, Peter Walsh.
"A full duty of candour would probably be the biggest advance in patients' rights and patient safety since the creation of the NHS. For decades, the NHS has frowned upon cover-ups but has been prepared to tolerate them. This will be an end to that."
The Royal College of Nursing backed the recommendation for candour in all cases of significant harm. "We have long felt that in many organisations there is still a culture of blame, fear and secrecy that makes it very hard for staff to admit when things have gone wrong and to learn from mistakes," said Dr Peter Carter, chief executive.
"As the review makes clear, a 'just culture' recognises that mistakes are usually caused by failures in systems or genuine human errors. This review is therefore absolutely right to see the duty of candour in the context of a wider commitment to patient safety, learning and improvements in care.
"Healthcare staff want to provide the best possible care to patients, and work hard to achieve this," he added. "However, healthcare is inherently risky and sometimes things will go wrong. When this happens, patients deserve an open and honest discussion with staff, and to know that lessons will be learned. This can only happen if staff are open with patients, in advance of care, about risks and the potential for harm, and the culture supports 'good conversations' and genuine partnership with patients in their care." The Guardian
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