Medical professionals must admit mistakes under new ‘duty of candour’ rules

open honesty reportNew guidelines will be unveiled for UK doctors, nurses and midwives instructing them to be open with patients when things go wrong and in cases of medical negligence.

In April 2015, the NHS introduced a rule that told NHS and private healthcare organisations to admit their mistakes honestly and as soon as possible. The same rule is to be applied to individual medics, and patients should expect a face-to-face apology.

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.

The two professional councils have also made clear that professionals need to have the support of an open and honest working environment where they are able to learn from mistakes and feel comfortable reporting incidents that have led to harm.

Andrew Taylor, Clinical Negligence specialist and a partner at Birchall Blackburn Law, says: “We’re sure the new guidance will be welcomed across the NHS by medical professionals. Mistakes happen, it’s a fact of life in high pressure environments, but what is important is how you deal with those mistakes.

“It can only be a good thing if doctors, nurses and midwives know they have the support to hold up their hands, apologise and then work as quickly as possible to get the patient the right help and support for rehabilitation. And any mistakes can be learned from and procedures put in place so they don’t happen again.

“The face-to-face apology is also vital. Often our clients simply want an apology but are forced to turn to us to get one. If NHS professionals embrace the guidelines and honest culture, then in many cases our assistance won’t be needed.”

The guidelines go so far as to spell out words that such an apology might include, such as “I am sorry”, to avoid any doubt.

Niall Dickson, Chief Executive of the General Medical Council, said: “We recognise that things can and do go wrong sometimes. 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 enquiry 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.”

Jackie Smith, Chief Executive of the Nursing and Midwifery Council, said: “We developed this joint guidance to help nurses, midwives and doctors to uphold a common duty of candour that is set out in their professional standards. They often work as part of a team and that should absolutely be our approach as regulators to ensure we are protecting the public.

“We believe that the public’s health is best protected when the healthcare professionals who look after them work in an environment that openly supports them to speak to patients or those who care for them, when things have gone wrong. We can’t stop mistakes from happening entirely and we recognise that sometimes things go wrong. The test is how individuals and organisations respond to those instances, and the culture they build as a result.”

Under the new guidance doctors, nurses and midwives should:

  • Speak to a patient, or those close to them, as soon as possible after they realise something has gone wrong with their care.
  • Apologise to the patient – explain what happened, what can be done if they have suffered harm and what will be done to prevent someone else being harmed in the future.
  • Use their professional judgement about whether to inform patients about near misses – incidents which have the potential to result in harm but do not.
  • Report errors at an early stage so that lessons can be learned quickly, and patients are protected from harm in the future.
  • Not try to prevent colleagues or former colleagues from raising concerns about patient safety. Managers must make sure that if people do raise concerns they are protected from unfair criticism, detriment or dismissal.

The guidance follows Sir Robert Francis QC’s call for a more open and transparent culture within healthcare following the failures in patient care at Mid Staffordshire NHS Foundation Trust. The Francis Report into the scandal, in which hundreds of patients suffered poor care and neglect, exposed how fears over the reputation of the Mid Staffs Trust led to a lethal culture of silence and cover-up when mistakes were made.

Our compassionate team of Clinical Negligence experts understand the worry and pain caused by medical mishaps.  Please get in touch with us on 0800 614 722 or 0333 321 2192 from a mobile.

Further reading:

General Medical Council: (Press Release) ‘Employers urged to create conditions which encourage doctors, nurses and midwives to admit mistake