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Draft candour guidance falls short on anti-bullying rules, claim campaigners

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The new professional guidance that demands doctors and nurses are open about their mistakes does not include an explicit warning against staff obstructing or bullying their colleagues, campaigners have claimed.

Draft proposals for the new professional duty of candour, unveiled last week by the General Medical Council and the Nursing and Midwifery Council, follows recommendations by Sir Robert Francis QC after his public inquiry into care failings at Mid Staffordshire NHS Foundation Trust.

“It only tells professionals in more detail what in theory they are already obliged to do”

Peter Walsh

Sir Robert called for a legal “duty of candour” on both organisations and individual clinicians, making it a criminal offence to obstruct others from exercising their responsibilities to be open and honest about errors in patient care.

In its response, the government backed a legal duty on organisations but rejected one for individuals. Instead it asked professional regulators to beef up codes of conduct, a process which is now underway.

But while last week’s draft guidance from the professional regulators states staff should encourage openness and not stop people from raising concerns, it contains no explicit warning against obstructing others from exercising their duty of candour.

Robert Francis

Robert Francis

Peter Walsh from the patient safety charity Action Against Medical Accidents highlighted that the Francis report recommendations had not been adopted.

“The production of guidance on the professional duty is a step in the right direction, but it only tells professionals in more detail what in theory they are already obliged to do,” he said.

“What will be necessary for us to have confidence in the professional duty of candour is a clear indication from the regulators themselves about what they will do differently,” he added.

He said there had been a failure of regulators in the past to promote and enforce existing rules, which would need to change if the new measures were to be success.

Both the GMC and the NMC said existing codes of conduct, which were in place when events at Mid Staffordshire took place, included guidance on bullying.


Peter Walsh

A spokeswoman for the NMC said: “Anyone who wishes to raise an issue of any kind should be free to do so in the best interest of the people in their care.

“To bully or obstruct someone who wishes to exercise their duty of candour goes against the fundamental principles of nursing and midwifery practice as they are set out in the [NMC] code,” she said.

The public consultation over the new guidance will run until 5 January.

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