The duty of candour is a legal requirement upon healthcare workers that came into force on the 27 November 2014 for health service bodies and from 1 April 2015 for other care providers.
The introduction of the regulation was in response to the Francis Inquiry in to Mid Staffordshire Trust that recommended, amongst other things, that a statutory duty of candour be imposed on healthcare workers.
What does the Duty of Candour mean?
The regulations dictate the steps that must be followed in order to inform a relevant person when a notifiable incident occurs and with the purpose of achieving a greater level of openness, transparency and candour as recommended in the Francis Inquiry.
What is a notifiable incident under the Duty of Candour?
A notifiable incident is any unintended or unexpected incident which occurs when a service user is being treated or cared for and that could result or appears to have resulted in the death, severe harm, moderate harm or prolonged psychological harm of a service user.
The regulations dictate identifies certain notifiable incidents as a set of unintended and unexpected outcomes that may arise during treatment or care.
- Death: whether immediate or potentially arising as a result of the notifiable incident
- Severe Harm: defined as a permanent lessening of bodily, sensory, motor, psychological or intellectual functions, including brain damage and removal of the wrong organ or limb
- Moderate Harm: defined as harm that leads to significant but not permanent harm or a moderate increase in treatment such as hospital admission or a return to surgery
- Prolonged Psychological Harm: defined as psychological harm that a patient has experienced, or is likely to experience, for a continuous period of at least 28 days.
What action do I need to take if a notifiable incident occurs?
You are required to make an oral notification to the relevant person or their representative as soon as is practicable one a notifiable incident has occurred and this oral notification must be made in person by a representative of the healthcare provider and include;
- Provide an account of the incident which, to the best of the health service body’s knowledge, is true of all the facts the body knows about the incident as at the date of the notification.
- Advise the relevant person what further enquiries the health service body believes are appropriate.
- Offer an apology.
- Follow this up by giving the same information in writing, and providing an update on the enquiries.
- Keep a written record of all communication with the relevant person.
What happens if I fail to comply with the Duty of Candour?
Failure to comply with the Act is a criminal offence punishable by a £2,500 fine. As a regulated activity it is also subject to checking and inspection by the Care Quality Commission (CQC) and failure to comply could result in loss of registration .
Does apologising affect my insurance as an admission of guilt?
An apology does not in itself constitute an admission of liability and whilst the requirements of the act require you to provide a detailed account of what has happened this also is not an acceptance of liability. In practical terms, Insurers engaged in the liability insurance market for healthcare providers and professionals will have to come to terms with the fact that providers are duty bound to provide this information and it is clear that is some cases the provision of the information may not fall short of an admission of liability.