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Implementing a ‘Duty of Candour’ will be a contractual requirement

The NHS will become more transparent under proposals to be set out by Health Secretary Andrew Lansley.

Over a million patient safety incidents are reported every year, so the Government will set out proposals that will require NHS providers to be more open and admit when things go wrong.

The new ‘Duty of Candour’ consultation will form part of the Government’s plans to modernise the NHS by making it more accountable and transparent and giving patients and local clinicians more power to hold the NHS to account. This was also signalled in the Government’s response to the independent Future Forum in June 2011.

The contractual Duty of Candour in healthcare will be an enforceable duty on providers to be open and honest with patients or their families when things go wrong ensuring they receive information about any investigations and encouraging the NHS to learn lessons.

Being open with patients when something goes wrong is a key component of developing a safety culture; a culture where all incidents are reported, discussed, investigated and learned from.

In particular, the consultation will ask stakeholders the best way of enforcing such a contractual duty and asks some key questions on the following areas:

What exactly should the Duty require the NHS to do?
What should the penalties be for breaching the duty?
Should organisations have to make an annual ‘declaration of openness’?
What support do patients and clinicians feel would help them act when they feel the NHS is not being open about an incident?

Health Secretary Andrew Lansley said:

"We must develop a culture of openness in the NHS. This is a key part of how a modern NHS should be – open and accountable to the public and patients to drive improvements in care.

“That's why we are introducing a requirement on providers to be transparent in admitting mistakes. We need to find the most effective way to promote openness and hold those organisations who are not open to account.

“A more transparent NHS is a safer NHS where patients can be confident of receiving high quality care."

Professor Sir Liam Donaldson, Chair of the National Patient Safety Agency, commented,

"When something goes wrong in healthcare, making the patient and family aware of it should be the norm. An honest mistake is something the NHS should learn from. It could save another patient's life in the future. Secrecy and cover-ups are not just patronising but they are dangerous because they suppress learning.

“Good practice elsewhere in the world shows that if such disclosure is done well, patients and families will often work positively with a hospital's staff to ensure their experience is part of the solution to making future care safer."

It was also announced today that another 13 groups of GPs and front-line clinicians have come forward to lead the way in modernising the NHS. In total there are now 266 pathfinder clinical commissioning groups (CCGs) across the country beginning to design high quality services to deliver the best results for their patients.

Notes to Editors

1. For more information, please contact the Department of Health press office on 0207 210 5221 or 07050 073 581 2. The consultation runs until 2 January 2010 and will be available this week at www.dh.gov.uk 3. Over one million patient safety incidents are reported to the National Patient Safety Agency’s National Reporting and Learning System (NRLS) every year. Of the patient safety incidents reported, Almost 790,856 (69 per cent) resulted in no harm to the patient;270,114 (24 per cent) resulted in low harm;69,154 (6 per cent) resulted in moderate harm;9,650 (0.6 per cent) resulted in death or severe harm. These are for incidents reported during the period January 2010 - December 2010 (published 10 August 2011) http://www.nrls.npsa.nhs.uk/resources/collections/quarterly-data-summaries/?entryid45=131140) 4. The consultation proposes to contractually require providers of NHS funded care to be open according to the principles of the ‘Being Open’ policy published by the National Patient Safety Agency. We propose that enforcement of the requirement to be open is limited to those incidents involving moderate and severe harm or death. 5. It is proposed that the requirement would be inserted into the NHS Standard Contracts, which set out standard terms and conditions that all organisations providing NHS-funded secondary or community care must agree to. This therefore includes the providers of NHS acute hospital, community, ambulance and mental health services. This means that any requirement placed in the NHS Standard Contracts would apply across NHS Trusts, NHS Foundation Trusts, the independent, charitable and voluntary sectors and social enterprises, where they are providing NHS-funded care.

Contacts:

Department of Health
Phone: 020 7210 5221
NDS.DH@coi.gsi.gov.uk