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Survey: Third of nurses may not understand proposed new honesty law


While most nurses say they know what is meant by the term “duty of candour”, at least one in five may not undestand it, suggest results from a major survey by Nursing Times.

The Mid Staffordshire Foundation Trust public inquiry report recommended in February that there should be a series of new laws requiring all NHS staff and directors to be open and honest when mistakes happen – a so-called statutory duty of candour.

As part of our annual survey, we asked readers whether they understood the meaning of the term “duty of candour” in reference to openness about errors and concerns.

Of the 2,200 respondents, 67% said “yes”, but 20% answered “no” and 13% were “unsure”.  

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

In its initial response to the Francis report, the government said it planned to introduce a legal duty of candour for trust boards, but has so far rejected the idea that it should apply to all staff. It is due to reveal its full response to Francis later this year. 

However, Nursing Times and Robert Francis QC believe that the duty to cover all NHS staff as well as senior managers – in order to provide greater protection for patients and frontline clinicians themselves.

For example, it would protect those who speak up by creating a specific criminal offence for anyone who tried to prevent a member of staff from highlighting a serious incident.

It has been suggested that some nurses and NHS staff mistakenly believe that a duty of candour simply compels them to raise concerns and would see them face legal action if they did not raise concerns.

However, this compulsion to raise concerns is already part of the Nursing and Midwifery Council’s code of conduct and is not the objective of the revised duty of candour. Rather it seeks to prevent managers from blocking those who have concerns.

Our annual survey was carried out from 21 August to 27 September and covered a range of topics including staffing levels, wellbeing and occupational health.


Are you able to Speak Out Safely? Sign our petition to put pressure on your trust to support an open and transparent NHS.


Readers' comments (10)

  • I think it is highly likely that nurses will have less trouble identifying the truth than the managers or MPs who are meant to be dealing with the information provided.

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  • How does the 33% who did not say yes breakdown in terms of experience/stage in their career or having English as their first language?

    I can easily imagine 30% of the population at large not knowing what candour means.

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  • Anonymous | 8-Oct-2013 8:02 am

    "I can easily imagine 30% of the population at large not knowing what candour means."

    that doesn't say much for the British public. Hopefully your estimate is incorrect.

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  • It doesn't surprise me in the least. Most of the colleagues in my workplace never lift a newspaper never mind a nursing publication. They have no idea of what is current in nursing. Quite a lot of them haven't a clue about what went on in Mid Staffs or what the Francis Report is. I dare any of you to ask around in your own workplace. I think it'll shock you.

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  • tinkerbell

    Anonymous | 9-Oct-2013 7:27 am
    Yeah been there, same here and probably most places. Mentioning the 'issues' since 2010, no longer do I rant on about them anymore at work cos' I think they just started looking at me and thought 'God she's off on one again'. I accept now that I was probably just stressing them out or frightening them by asking 'what do you think?'. Come on just a little bit of a response will do before we start looking at the Avon catalogue. That lipstick looks nice. How much is it?

    Recently mentioned the Francis report/Mid staffs in a team meeting one morning, it was in context with what was being discussed, got a lot of blank looks and a few nods. Deadly silence. Swiftly moving on.

    I was trying to get a response from some colleagues recently about some nursing issue, can't remember which one now, there are so many, think it was about the excessive paperwork and zombie tick boxes cos' a colleague said she couldn't think straight anymore as she'd been at that computer all morning doing paperwork and I answered 'this isn't nursing is it?' My manager overheard me and said 'what are you trying to do? I have to do it as well'. I replied 'i'm trying to raise a rabble'. She (query) jokingly reprimanded me and I said 'don't worry I am unable to rouse any rabble on any issue'.

    I will continue to inform my colleagues in my workplace of what is going in relation to our nursing profession, managers present or not. I now just read out the headlines leave it out there for them to discuss or not. Pass me that Avon catalogue when you've finished I want to look nice for when this all goes tits up.

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  • In the light of some of the above comments, is CPD just a joke for some nurses? might be a bit of a shock if the NMC demand their portfolio.

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  • Anonymous | 9-Oct-2013 2:09 pm
    Anonymous | 9-Oct-2013 7:27 am

    I think most nurses keep up to date with their own areas of practice and competence, but are unaware of and disconnected from the wider picture within Nursing. As long as they can prove that they are current and competent within their own area, then they have nothing to fear from the NMC (itself an organisation dogged by bullying and breathtaking incompetence).

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  • The NMC never asks for the CPD portfolio unless it is someone returning to practice - and even then not all the time. This came straight from the horse's mouth when I rang them as a manager to ask them about this. They have no resource to manage it.

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  • clearly the regulations on CPD the NMC impose on nurses and how they actually implement them them through spot checks of the portfolio are two different matters.

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  • I raised issues both during and after leaving a post. No action was taken. Nurses /doctors noting on records that a patient was discharged from the unit when they were still in in the unit, this in my opinion in fraud. Completing incidents forms and no feed back being given on investigations, or extra training to people involved. Like me, 2 other nurses have left the unit because as I see it we identified poor practice

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