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Duty of candour extended to independent doctors

The statutory duty of candour which was introduced for NHS bodies in November 2014, has today (April 1) been extended to cover all other care providers registered with the CQC, including doctors working in primary care and those working in independent practice in England.

The introduction of statutory duty of candour for GPs and independent practitioners means they will now have a legal obligation to tell a patient or their representative if a notifiable patient safety incident occurs, provide a full explanation of what happened and offer an apology.

While the duty applies to organisations rather than individuals, CQC guidance makes it clear that all staff must cooperate in order to ensure that the duty is met. Organisations are expected to tell patients about a notifiable patient safety incident as soon as is reasonably practicable, providing a full explanation of the incident, an apology and explaining what further action will be taken.

For over 50 years the MDU has advised doctors to tell patients when things have gone wrong, to apologise and to try and put things right. Furthermore, doctors are ethically required by the GMC to apologise and provide an explanation to patients when an incident occurs. With this in mind, being open and honest will be second nature to most doctors.

Clinicians need to know that, unlike their ethical duty which applies to all circumstances where a patient is harmed when something goes wrong, the statutory duty of candour only applies to incidents where a patient suffered (or required treatment to prevent) unintended harm resulting in death or specified conditions, such as impairment of sensory, motor or neurological functions or prolonged pain or psychological suffering.

Doctors will need to continue to tell patients promptly when things go wrong.

Careful note-taking will be important, as will be notifying CQC without delay if the duty applies. This is because the new duty of candour in primary care and independent practice mirrors existing requirements to tell CQC if patients suffer certain specified types of unintended harm.

Duty of Candour advice at-a-glance:

– Continue to be open and honest with patients

– Cooperate fully to ensure that their organisation’s obligations under the CQC guidance are met

– Tell patients or their representative about any notifiable safety incidents as soon as is practicable after the incident

– Provide reasonable support to patients after an incident has occurred

– Ensure that once the patient is advised verbally of an incident it is followed up with a written note of the discussion

– Keep copies of all correspondence with patients and make details on the patient’s medical record.

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