37. We accept this recommendation. A duty of candour has been introduced.
38. A lack of openness and honesty at Morecambe Bay was a fundamental cause
of both the distress of the families, and of the inability of the Trust to learn from
serious incidents. At a regulatory, provider and professional level action is being
taken to increase the involvement of patients/relatives in investigation of serious
incidents.
39. All providers must now comply with a new legal requirement for openness – the
duty of candour – as a condition of their registration with the Care Quality
Commission and hence a condition of their providing care. Providers must now
inform patients where there has been a significant failure in their care or treatment
and set out what further enquiries will be undertaken into the incident and to inform
patients of the outcome of such enquiries. Registered providers must also seek and
act on feedback from patients in order to improve services. We believe that these
requirements address the recommendation. However, we will keep the effectiveness
of the duty of candour under review and will consider whether further changes are
needed in due course.
40. The new NHS England Serious Incident Framework, published on 27 March
2015, also requires providers to: comply with national requirements and guidance in
relation to being open with patients or their representatives when things have gone
wrong; support and enable staff in disclosing incidents to patients and their
representatives; and involve patients and families/carers in investigations, sharing
findings and facilitating specialist support where appropriate.
41. In addition, all healthcare professionals including doctors, nurses and midwives
have an individual professional duty of candour, which is a responsibility to be open
and honest. This responsibility is set out in their respective professional codes of
conduct. In October 2014, the Department welcomed a joint statement by eight of
the statutory regulators of healthcare professionals, including the General Medical
Council and the Nursing and Midwifery Council, reaffirming that every healthcare
professional must be open and honest with patients when something goes wrong
with their treatment or care. Similarly, the Department is pleased to note that the
General Medical Council and the Nursing and Midwifery Council launched their new
joint guidance on the professional duty of candour on 29 June 2015, which includes
advice on apologising to patients when things go wrong.
42. The Government fully expect both individuals and organisations to comply with
these processes; and will also seek further advice from the expert group considering
the national investigations capability on:
• how any new investigation function can ensure a genuine commitment to
openness,
transparency
and
engagement
with
patients
and
their
families/carers throughout the investigation process; and,
• whether this can be made an integral objective of any investigative process.