London: NHS staff should be put under a legal “duty of candour” to own up when mistakes affect patients, a public inquiry into the Mid Staffordshire hospital care scandal will recommend.
The move will form part of a series of measures designed to make hospitals safer which Robert Francis QC will outline in his report of the 31-month public inquiry into what is widely considered to be the worst care scandal in many years.
The Liberal Democrats and leading patient groups support the move. The public inquiry, into why poor care at Stafford hospital was allowed to persist between 2005 and 2009, heard evidence that had NHS staff already been subject to such an obligation then, failings in care would have been detected and stopped much sooner.
If implemented by the government it would mean that NHS personnel had to start being open and honest when they made an error, such as giving a patient the wrong drug or getting the dose of their medication wrong.
“If Robert Francis is recommending a statutory duty of candour and the government accept it, it would be the biggest advance in patient rights and patient safety in the history of the NHS,” said Peter Walsh, chief executive of the patient safety group Action against Medical Accidents.
“Openness and transparency are essential components of patient safety. If people feel comfortable squeezing things under the carpet when things go wrong in healthcare, then lessons will continue not to be learned. The government surely must accept this recommendation”, Walsh added.
Francis’s endorsement of a duty of candour potentially poses problems for the government. Although Lib Dems such as the health minister, Norman Lamb, support it, the Department of Health in November pushed ahead with plans to change the NHS constitution by putting NHS trusts rather than individual staff under a contractual duty of candour.
Walsh and others claim that is a watered-down version of the binding duty on doctors and nurses which patient organisations say is the only sure way of finally ending the NHS’s stubborn culture of secrecy around errors which harm or kill patients.
The Patients Association and National Voices, an umbrella group representing 130 health charities, have also been lobbying for that change.
David Cameron will lead the government’s response to the Francis report, which will criticise an array of organisations and individuals across the NHS for doing too little either to spot problems at Stafford hospital or intervene.
Francis will detail the moves he believes are necessary to minimise the chances of what he in a previous report into the scandal called “shocking” care ever happening again at another hospital.
He also heard evidence in favour of legally-binding minimum staffing levels in hospitals to help guarantee safe care, such as those that already exist in Australia.
He is expected to argue for the NHS’s different supervisory and regulatory bodies to work together much more closely and share information to help detect care failings sooner.
