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Legislation on safe staffing and 'duty of candour' laid before parliament

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NHS organisations that fail to provide safe care could face immediate prosecution and hefty fines, under new legislation unveiled by the government this week.

The new law will set out 11 “fundamental standards of care” that all health and social care providers must live up to, including ensuring they have enough skilled and qualified staff.

It will also mean health and social care providers could face fines of up to £50,000 if they fail to protect patients from abuse, do not provide safe care, or if patients are harmed or put at risk by not getting enough to eat or drink.

“This is a key milestone in delivering on Francis’ recommendations”

Norman Lamb

In addition, it will be an offence not to own up to mistakes that cause “significant harm” to patients.

From October this year all NHS organisations will be required to comply with this new “duty of candour” to ensure they are open and honest when things go wrong – one of the reforms Nursing Times has been calling for as part of its Speak Out Safely campaign.

This means trusts must automatically report any errors that lead to a patient dying or suffering “moderate” or “severe” harm – or face prosecution and a fine of up to £2,500.

While individual members of staff cannot be held responsible if this overarching duty is not met, they will be given training to ensure it is implemented across a hospital or care setting.

The new regulations form part of the government’s response to the Francis Inquiry into care failings at Mid Staffordshire Foundation Trust, which was published in February 2013.

The 11 care standards are expected to come into force for all providers by April 2015 – if the new legislation is agreed by parliament.

They include ensuring “sufficient numbers of suitably qualified, competent, skilled and experienced staff”, and that all patients are treated with dignity and respect.

The standards will form part of inspections by the Care Quality Commission, with the regulator able to hold providers to account if they fail to meet them.

This includes new powers to prosecute without issuing a warning notice for breaching some standards, including those covering hydration and nutrition, safe care and abuse, and treatment without consent.

While breaching the standard for safe staffing is not automatically a criminal offence, failing to ensure the right staffing levels could lead to prosecution under other key standards such as failing to provide safe care.

Norman Lamb

Norman Lamb

“This is a key milestone in delivering on Francis’ recommendations and will help us to build a more open and accountable NHS,” said health minister Norman Lamb.

“Patients are at the forefront of these new laws, which will help create a more open, honest and safety driven NHS.”

The fundamental standards of care are:

  • care and treatment must be appropriate and reflect service users’ needs and preferences
  • service users must be treated with dignity and respect
  • care and treatment must only be provided with consent
  • care and treatment must be provided in a safe way
  • service users must be protected from abuse
  • service users’ nutritional and hydration needs must be met
  • all premises and equipment used must be clean, secure, suitable and used properly
  • complaints must be appropriately investigated and appropriate action taken in response
  • sufficient numbers of suitably qualified, competent, skilled and experienced staff must be deployed
  • persons employed must be of good character, have the necessary qualifications, skills and experience, and be able to perform the work for which they are employed
  • registered persons must be open and transparent with service users about their care and treatment (the duty of candour)



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