May I be candid? New duty of candour
On 13th October 2014 the GMC, GDC, NMC, GPhC, GCC, GOC and GOsC all signed a joint statement marking their commitment to the professional duty of candour for all healthcare professionals. The joint statement has been signed by the Chief Executive and Registrar for each regulator, who have described the duty of candour as being, “an essential duty for all professionals working with patients.”
The joint statement defines candour in the following way:
“Health professionals must be open and honest with patients when things go wrong. This is also known as the ‘duty of candour’.”
Currently all healthcare professionals are obliged to be honest with patients when things have gone wrong with their care. However the Francis report following the Mid Staffordshire inquiry exposed a cultural lack of candour within the healthcare sector. The Francis Report defines candour as, “The volunteering of all relevant information to persons who have or may have been harmed by the provision of services, whether or not the information has been requested and whether or not a complaint or report about that provision has been made.” Following the Francis Report, it has become increasingly accepted that there needs to be a complete culture shift regarding candour in the healthcare sector.
Having had time to review the Francis Report, each healthcare regulator is keen to promote a culture of openness and honesty amongst their registrants. The joint statement provides a clear message that the duty of candour is a consistent requirement across the board.
The aim of having a professional duty of candour is to reach a position whereby all professionals working in the healthcare sector feel free to raise their concerns, in an environment where they will be supported, promoting a learning rather than blame culture. A significant aspect of the duty of candour will be the regulatory obligation on professionals to raise concerns about poor practice where appropriate, supporting and encouraging others to raise concerns and not to seek to prevent someone from raising concerns.
As the professional duty of candour becomes embedded into the culture amongst healthcare professionals, it is hoped that it will no longer be acceptable to walk by the other side of a ward, knowing that unacceptable practice is occurring, but doing nothing about it.
In clinical practice the duty of candour is likely to include:
- Registrants telling the patient when something has gone wrong;
- Offering an appropriate remedy, or support to put matters right where possible;
- Explaining in full any short and long term consequences of the mistake.
Candidly it is feared that the anticipation of repercussions from senior members of respective professions, together with tiers of management, may continue to have a negative impact for a while longer, before the professional duty of candour transforms the culture in the healthcare system in the UK.
It is expected that before long, allegations of a lack of professional candour, will feature in fitness to practise investigations, to send appropriate messages to registrants. Defence lawyers in the Medic Assistance Scheme can advise and represent all healthcare professionals who face fitness to practise investigations.