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Legal duty of candour on hospital boards could support nurses

Government plans to place criminal sanctions on healthcare providers that lie to patients about harmful mistakes during their care will support nurses who speak out about concerns, according to patient safety campaigners.

Health secretary Jeremy Hunt announced plans for a statutory “duty of candour” on all health and care organisations as part of last Tuesday’s government’s response to the Mid Staffordshire Foundation Trust Public Inquiry report.

It will require hospitals and other service providers to inform people “if they believe treatment or care has caused death or serious injury, and to provide an explanation”.

Its introduction is one of the targets of the Speak Out Safely campaign, which was launched last month by Nursing Times with the aim of helping strengthen protection for frontline staff and increase honesty and transparency in the NHS.

The campaign is also calling for a similar duty of candour to apply to individual health professionals and managers. Mr Hunt said the government was stopping short of implementing a duty of candour on individuals for the time being.

However, the issue will be revisited as part of a review into making “zero harm a reality in the NHS”, which is due to report in July.

Public Concern at Work’s director of policy Francesca West told Nursing Times a duty on providers was the right direction to go.

“Professionals already have a duty to raise concerns, but that can be really challenging in an environment where it isn’t welcomed,” she said. “Placing the responsibility at the top of organisations means [boards] are going to have to be much more proactive about making sure their staff feel able to do so.”

Peter Walsh, chief executive of Action Against Medical Accidents, said a legally enforceable duty of candour represented the “biggest advance in patient safety and patients’ rights in the history of the NHS”.

The detail of how the duty would work and the likely sanctions are still being discussed.

Nursing Times editor Jenni Middleton said: “We support this move as a step in the right direction as it is in line with more openness in the NHS, which our Speak Out Safely campaign is pushing for.

However, we’d like to see the government promise to look into individual duty of candour so that the onus is on individual staff, including clinicians and managers, to speak out and protect patients. The buck cannot then be passed and no one can turn a blind eye to care failings.”


Sign our Speak Out Safely petition to support a transparent and open NHS. We are calling on the government to implement recommendations from the Francis report that will increase protection for staff who raise concerns about patient care.

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