UK: New duty of candour guidelines

Ian Cohen has highlighted the June 2015 introduction of duty of candour guidelines by the General Medical Council UK & the Nursing & Midwifery Council, entitled Openness and honesty when things go wrong: the professional duty of candour.

The document has similarities to, though in some ways go further than, those which have been in place in Australia for some years, contained in the Medical Board of Australia Good Medical Practice Code of Conduct at clause 3.10:

When adverse events occur, you have a responsibility to be open and honest in your communication with your patient, to review what has occurred and to report appropriately.

When something goes wrong, good medical practice involves:

  •  Recognising what has happened.

  • Acting immediately to rectify the problem, if possible, including seeking any necessary help and advice.

  • Explaining to the patient as promptly and fully as possible what has happened and the anticipated short-term and long-term consequences.

  • Acknowledging any patient distress and providing appropriate support.

  • Complying with any relevant policies, procedures and reporting requirements, subject to advice from your medical indemnity insurer.

  • Reviewing adverse events and implementing changes to reduce the risk of recurrence (see Section 6).

  • Reporting adverse events to the relevant authority, as necessary (see Section 6).

  • Ensuring patients have access to information about the processes for making a complaint (for example, through the relevant health care complaints commission or medical board).

It is interesting to see that the UK document speaks of independent advocacy services, in addition to complaints bodies:

You should also give patients information about independent advocacy, counselling or other support services that can give them practical advice and emotional support”.

That is footnoted with a suggestion:

For example, you could direct them to Action against Medical Accidents (AvMA) or to their local Healthwatch group in England, Patient and Client Council in Northern Ireland, the Patient Advice and Support Service in Scotland or the Community Health Council in Wales.

The UK document also provides that the apology should be recorded in the patient’s clinical notes.

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