Openness, transparency and candour
The public inquiry identified the principles of openness, transparency and candour as the ‘cornerstone of healthcare’ and that ‘every healthcare organisation and everyone working for them must be honest, open and truthful in all their dealings with patients and the public, and organisational and personal interests must never be allowed to outweigh the duty to be honest, open and truthful.’
The inquiry pointed to the lack of uniformity by which these principles are upheld by organisations and healthcare professionals. There are measures that will give people more confidence in the information they receive from the NHS and will make the NHS more open, honest and accountable.
The government has introduced a new statutory duty of candour that will ensure patients are given the truth when things go wrong, and that honesty and transparency are the norm in every organisation.
The new duty will be overseen by the Care Quality Commission and come into force during 2014.
The NHS Constitution emphasises the importance of honesty and openness and was updated in March 2013 to reflect the contractual duty of candour.
The General Medical Council and the Nursing and Midwifery Council will be working with the other regulators to agree consistent approaches to candour and reporting of errors, including a common responsibility across doctors and nurses and other health professions to be candid with patients when mistakes occur whether serious or not.
Subject to the passage of the Care Bill 2013, a new criminal offence will be introduced to stop providers giving false or misleading information.
The government now requires the inclusion of an explicit clause in compromise agreement to make it clear that staff can make a protected disclosure in the public interest regardless, and the Public Interest and Disclosure Act has been strengthened so that an individual who has suffered a detriment from a co-worker as a result of blowing the whistle, now has the right to expect their employer to take reasonable steps to stop this.
The Care Quality Commission is using staff surveys and the whistleblowing concerns it receives as part of the data in its new intelligent monitoring system, and since September the Care Quality Commission’s new inspection system includes discussions with hospitals about how they deal with, and handle, whistleblowers.
Recommendation 173Organisations and staff must be honest, open and truthful
Recommendation 174Candour in the event of death or serious harm
Recommendation 175Patients questions answered fully and honestly
Recommendation 176Statutory duty to disclose information
Recommendation 177Public statements must be full and honest
Recommendation 178Duty of candour to be included in the NHS Constitution, employment contracts, policies and guidance
Recommendation 179Gagging clauses to be prohibited
Recommendation 180Guidance and policy on openness
Recommendation 181Statutory duty of candour for patients injury
Recommendation 182Duty on individuals to provide truthful information