The Department of Health has on 11 October 2011 issued a paper for consultation proposing the implementation of a duty of candour on NHS providers.
It is claimed that the NHS will become more transparent under proposals set out by Health Secretary Andrew Lansley.
The new ‘Duty of Candour’ is said to form part of the Government’s plans to modernise the NHS by making it more accountable and transparent, and giving patients and local clinicians more power to hold the NHS to account.
The aim is so establish an enforceable duty for Healthcare providers to be open and honest with patients, or their families, when things go badly wrong to ensure they receive information about any investigations, and in so doing encourage the NHS to learn lessons, which in turn will impact on Patient Safety.
The consultation proposes to contractually require providers of NHS funded care to be open according to the principles of the ‘Being Open’ policy, published by the National Patient Safety Agency.
We are told that over one million patient safety incidents are reported to the National Patient Safety Agency’s National Reporting and Learning System (NRLS) every year.
Of the patient safety incidents reported in 2010:
• Almost 790,856 (69 per cent) resulted in no harm to the patient;
• 270,114 (24 per cent) resulted in low harm;
• 69,154 (6 per cent) resulted in moderate harm;
• 9,650 (0.6 per cent) resulted in death or severe harm.
The proposals as they stand appear to be fundamentally flawed. We are told that to avoid unnecessary bureaucracy, enforcement of the requirement to be open will be limited to incidents involving moderate and severe harm, or death (around 70,000 - 80,000 per year), as defined by the National Patient Safety Agency, in other words only 6.6% of all reported incidents. This is not enough.
In addition, part of the proposed sanctions for non compliance includes financial penalties imposed on healthcare providers. With resources already stretched it is hard to see how such a penalty if imposed will really help. Victims of medical accidents want transparency, but they also want accountability at the grass roots level. They want to know that someone has been held personally accountable for their errors. It is difficult to see how the proposals, as they stand, will help.
Health Secretary Andrew Lansley has been quoted as stating that “We must develop a culture of openness in the NHS. This is a key part of how a modern NHS should be – open and accountable to the public and patients to drive improvements in care.
“That’s why we are introducing a requirement on providers to be transparent in admitting mistakes. We need to find the most effective way to promote openness and hold those organisations who are not open to account.
“A more transparent NHS is a safer NHS where patients can be confident of receiving high quality care.”
It is a bold statement but there has to be concern that the proposals as they stand will simply not work.