New 'duty of candour' rules instruct medics to admit mistakes

By Dominic Hughes
Health correspondent, BBC News

  • Published
Media caption,
Dominic Hughes reports on new guidelines to make NHS staff more open and honest when things go wrong

New guidelines are being unveiled for doctors, nurses and midwives across the UK on being honest and open with patients when things go wrong.

Known as a "duty of candour", the guidelines make clear that patients should expect a face-to-face apology.

In April, the NHS introduced a rule that told NHS and private healthcare organisations to admit their mistakes candidly, and as soon as possible.

Now the same rule is to be applied to individual medics.

Say sorry

Detailed guidance makes clear staff should tell the patient as soon as possible when something has gone wrong, and what it might mean for their health.

The guidance also makes clear that patients or their families should receive a face-to-face apology.

For the avoidance of doubt, it even spells out words that such an apology might include, such as "I am sorry".

The guidance was drawn up by the General Medical Council and the Nursing and Midwifery Council and applies to more than 950,000 doctors, nurses and midwives working in the UK.

The Francis Report into the scandal at Stafford Hospital, in which hundreds of patients suffered poor care and neglect, exposed how fears over damage to the reputation of the Mid Staffs Trust led to a lethal culture of silence and cover-up when mistakes were made.

Niall Dickson, chief executive of the General Medical Council, said that while things can and do go wrong, it is what doctors, nurses and midwives do afterwards that matters.

"If they act in good faith, are open about what has happened and offer an apology this can make a huge difference to the patient and those close to them.

"We also want to send out a clear message to employers and clinical leaders - none of this will work without an open and honest learning culture, in which staff feel empowered to admit mistakes and raise concerns.

"We know from the Mid Staffordshire inquiry and from our own work with doctors that such a culture does not always prevail.

"It remains one of the biggest challenges facing our healthcare system and a major impediment to safe effective care."

Jackie Smith, chief executive of the Nursing and Midwifery Council, said it was important there were common standards for nurses, midwives and doctors.

"They often work as part of a team and that should absolutely be our approach as regulators to ensure we are protecting the public.

"We believe that the public's health is best protected when the healthcare professionals who look after them work in an environment that openly supports them to speak to patients or those who care for them, when things have gone wrong.

"We can't stop mistakes from happening entirely and we recognise that sometimes things go wrong.

"The test is how individuals and organisations respond to those instances and the culture they build as a result."