Hospital Dr News

Views sought on ‘duty of candour’ introduction

NHS trusts will have a new ‘duty of candour’ from October, obliging providers to be open and honest when things go wrong.

The Care Quality Commission (CQC) has drafted guidance on how the 46,000 health and adult social care providers and services that it regulates across England can meet the government’s new regulations on care and what actions it will take when they fail.

In the wake of the Mid Staffs Inquiry, the new regulations (called ‘fundamental standards’) are more focused and clear about the care that people should always expect to receive. They were laid before Parliament earlier this month and will come into effect by next April.

CQC has issued its draft guidance on how providers can meet the eleven fundamental standards as part of a public consultation.

Alongside this, CQC is asking for views on how it will use its strengthened enforcement powers, as set out in the Care Act 2014.

These will allow CQC to decide on the most appropriate enforcement action to take when care falls below the required standard rather than starting at the bottom of the scale. This includes CQC being able to prosecute providers without having to issue a warning notice first.

Once finalised, the guidance will help providers to understand how they can meet the new regulations and when they do not, what actions CQC will take.

David Behan, chief executive of the Care Quality Commission said: “We are consulting on our proposed guidance on how providers can meet the requirements of the new regulations and on how we intend to use our enforcement powers.

“It is essential that CQC uses these new responsibilities well to encourage a culture of openness and to hold providers and directors to account when care fails people.

“We have already started to inspect services against the five key questions that matter most to the people who use them – are they safe, effective, caring, responsive to people’s needs, and well-led. This helps our inspection teams to identify good care.

“Where our inspection teams identify poor care, this guidance will help us to determine whether there is a breach of regulations and if so, what action to take. In some cases, this will mean we will use our powers to prosecute.

“For providers, this will help them to make applications to register or vary their registration with CQC, and to make sure their services do not fall below acceptable levels.”

CQC will run its consultation for 12 weeks, ending on Friday 17 October 2014.

Alongside this, CQC is running a separate consultation for six weeks (ending on Friday 5 September), specifically on how NHS trusts can meet the duty of candour and ‘fit and proper person’ requirements.

The fit and proper person test seeks to make NHS senior managers more accountable, with the CQC able to insist on the removal of directors that fail this test.

A review – Building a Culture of Candour – by Sir David Dalton, Salford Royal’s CEO, and Professor Norman Williams, the RCS president, recommended that the threshold for telling patients when things go wrong should be where there has been ’significant harm’.

Sue Covill, director of employment services at the NHS Employers, commented: “These are two critical consultations for providers and the regulatory system to get right. They have an important role in ensuring standards and new processes will support employers with the work they are leading on an open and transparent NHS.

“The October implementation date for fit and proper persons and the duty of candour requirements is fast approaching. We will be encouraging employers to engage with us and the proposals over the next six weeks to build on what has been prepared and to ensure the practical implementation issues are considered and understood. We need this to work if we are to retain and attract high quality leaders.”

However, defence bodies have argued that a ‘duty of candour’ is unnecessary.

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One Response to “Views sought on ‘duty of candour’ introduction”

  1. Malcolm Morrison says:

    Sounds good in principle; it will be interesting to see how it works in practice.

    So long as we have ‘Nelsonian-type’ leaders in the NHS – who ‘turn a blind eye’ to the realities – I can foresse a ‘News of The World style’ trial where those ‘at the top’ will plead that ‘they were not aware’ of what was going on!

    I hope that such a plea is met with the response “Why didn’t you know?” and “You should have known”. If it can be shown that any whistle-blower had tried to ‘alert’ them to the problem, then their plea would fail.

    Thus, this may well protect whistle-blowers from persecution!

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