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Hospitals to be forced to own up to mistakes


NHS organisations will be required to tell patients when mistakes have been made and their safety compromised under a contractual duty of candour announced by the Government.

From April 2013 the NHS Commissioning Board will include a contractual duty of candour in all commissioning contracts.

Announcing the change, health minister Dan Poulter said the duty would boost transparency and openness, increasing patient confidence.

He said the government could not wait for the Mid Staffordshire Foundation Trust public inquiry report, which is expected early in 2013, to impose the measure. However, he said ministers would take further action, based on the recommendations of inquiry chair Robert Francis QC.

But Peter Walsh, chief executive of patient charity Action against Medical Accidents, said the government was “not going far enough” by not making the duty an essential standard, as defined by the Care Quality Commission.

“The essential standards are written in law and the government has consciously chosen not to give that status to a duty of candour,” he said.

The contractual duty will be used by clinical commissioning groups and included in their contracts with NHS providers.

It will require hospitals to actively tell patients if their safety has been compromised.

The duty will also apply to private providers contracted to deliver NHS-funded care using the NHS Standard Contract.

Under the duty, chief executives of NHS organisations that are deemed by commissioners not to be open with patients could be required to apologise in writing to the patient. The chief executives will also have to report the breach to the Care Quality Commission.

The Department of Health announcement said “strict action plans” to prevent the same mistakes happening again could be required with repeated breaches leading to more “stringent” action.

Dr Poulter said: “When mistakes are made, we want them acknowledged, patients informed and lessons to be learnt.

“The importance of an open culture cannot be underestimated. We expect Robert Francis QC will make further recommendations on the duty of candour when the Mid Staffordshire inquiry is published, and we are committed to taking whatever further action we think is needed as a result.

“But we cannot wait - creating this contractual duty of candour now ensures that NHS contracts for the next financial year will champion patients’ rights to basic honesty, as well as safe care.”


Readers' comments (5)

  • will they also be required to apologise for appalling staffing levels which compromise care, for not having 24/7 facilities available which delay care and for employing uncaring managers who ignore staff concerns?

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  • tinkerbell

    sad that the truth has to be 'forced' out of institutions especially when peoples lives are at stake.

    If hospitals can't provide safe care and people come out worse than they went in if they come out at all at the end of their stay why would any person feel safe about going into hospital?

    If lack of staff is causing patients to suffer deal with it at source, otherwise those who allow short staffing levels to compromise patient care and safety are colluding in manslaughter and criminal behaviour when harm comes to a person in hospital which could have been avoided if there were more staff needed to do the job safely.

    Going into a short staffed hospital with high dependency needs is not safe.

    It sounds like a few Chief Execs should be standing trial for allowing this to continue. They would soon change their behaviour if it affected them at a more personal level. They are getting away with it scott free.

    Uncaring managers who ignore staff concerns another load of criminals.

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  • hospitals should be safe for patients and for staff, they are not safe for either. management need to be held responsible, until they are nothing will change.

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  • michael stone

    As a culture change within the NHS, getting managers and staff to own up to their mistakes without having to 'drag it out of them' is a cracker !

    I quite often read of reports being never published, because trust legal bods advise 'if this is published, we might get sued' !

    Patients and relatives, can usually tell when anyone - a nurse, a doctor or the CE - 'is being evasive': and it just winds patients and relatives up !

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  • michael stone

    PS to my earlier post - it seems easiest to get staff who are NOT 'bothered by what my boss will then say/do' (in the sense that they don't have a boss - for example, a GP) to just admit to what they actually did: many staff seem to be impeded by 'what will my boss do/think'.

    In my own very limited experience, I found it much easier to get 'straight answers' out of a GP than out of DNs.

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