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The “Duty of Candour” in the context of the National Health Service (NHS) in the United Kingdom refers to a legal and ethical obligation for healthcare organizations and professionals to be open and honest with patients and their families when something goes wrong with their healthcare or treatment. This duty is enshrined in law in England through the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The General Medical Council (GMC) in the United Kingdom also has its own guidance and standards related to the Duty of Candour for medical professionals.

The GMC’s guidance on the Duty of Candour aligns with the broader principles of patient-centred care, professionalism and accountability. It emphasizes the importance of maintaining trust between doctors and their patients when things do not go as planned in medical care. Doctors who fail to meet their Duty of Candour obligations may face professional and regulatory consequences from the GMC.

Duty of candour places responsibility on the providers (NHS Trusts) so that they remain open, honest and transparent with users (patients). Duty of candour legislation sets out specific requirements that should be followed when things go wrong and unintended notifiable safety incident occur. This includes:

  • Inform people about the event
  • Support those affected (patient, family, staff)
  • Offer honest and truthful information
  • Offer an apology as needed

The term “notifiable safety incident” is used when unexpected, unintended and unwanted incident occurs in a service by a user that can or potentially lead to

  • Death (not due to illness or underlying illness)
  • Severe harm (physical or mental)
  • Require treatment by healthcare professional to prevent above.

Key points regarding the Duty of Candour are as follows:

Openness and Honesty: Healthcare providers should remain open and honest with patients and their families when things go wrong with their care. This includes providing a full and truthful account of what happened, why it happened, and what is being done to rectify the situation.

Timely Disclosure: Information about adverse events or incidents should be disclosed to the patient as soon as possible. This allows patients to be informed about their care and treatment promptly.

Record-Keeping: Healthcare providers are expected to maintain accurate records of incidents, including details of what happened, how it happened, and the steps taken to address the situation.

Learning and Improvement: Healthcare organizations are encouraged to use incidents as opportunities for learning and improvement. This includes conducting thorough investigations, identifying root causes and implementing changes to prevent similar incidents in the future.

Apology: When appropriate, healthcare professionals and organizations are encouraged to apologize to patients and their families for any harm or distress caused by the incident. An apology is seen as a crucial aspect of candour.

Support and Redress: Patients and their families should be provided with appropriate support and information on how to seek redress or compensation if they have suffered harm due to healthcare failures.

Regulatory Oversight: Regulatory bodies such as the Care Quality Commission (CQC) in England monitor compliance with the Duty of Candour and can take enforcement actions against organizations that do not meet their obligations.

In summary, the Duty of Candour aims to promote a culture of transparency and accountability in healthcare, where patients are actively involved in understanding and addressing incidents that may have caused them harm. It also helps to improve patient safety by encouraging healthcare organizations to learn from their mistakes and make necessary improvements to prevent future occurrences.

Book a one to one coaching with us to learn how to integrate duty of candour and other on current NHS issues in your responses. 

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