Exclusive: duty of candour will not work unless it applies to staff, says Francis
Plans to introduce a statutory “duty of candour” on NHS providers will not work on its own and will leave patients at risk, according to Robert Francis QC.
The barrister, who led the public inquiry into the care failings at Mid Staffordshire Foundation Trust, said a similar duty should also apply to staff and without it organisations risked missing potential patient safety warning signs.
Mr Francis recommended in his inquiry report that individual clinicians should be required to tell their manager about any incident where a patient experienced serious avoidable harm or death. Their employer would then be required to tell the patient or their relatives, and provide information and an explanation.
Clinicians would not be required to tell patients directly and any information “conveyed under the statutory duty of candour” would not be used against them in criminal or civil legal action.
Nursing Times’ Speak out Safely campaign is calling for a duty of candour in-line with Mr Francis’ recommendations, which would cover both organisations and individuals.
However, the government has so far said it would only impose a duty of candour on NHS organisations, which it plans to do so through new powers given to the Care Quality Commission.
In response, Mr Francis said: “The bit that is missing from the jigsaw would seem to be getting the employees to tell their employer about things that have happened.”
He said an organisation could only comply with a statutory duty of candour “if it is told by its employees what has been going on”.
Asked if he thought a lack of a duty on individuals put patients at risk and meant warning signs could be missed, he said: “I think it does both.”
Mr Francis also reiterated his belief that it should be made a criminal offence for anyone to “wilfully obstruct” a member of staff from complying with a statutory duty of candour.
He said this would prevent bullying or pressure from colleagues and managers to stop staff from speaking up, and would give better protection for those prepared to speak up.
“What we are talking about is something so important and so demonstrated not to occur sufficiently that we need to back it up with statutory laws,” he told Nursing Times.
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