More than nine in ten doctors are aware of and comply with their duty to be open and honest with patients when something goes wrong in their care, according to a survey published today by the Medical Defence Union (MDU), but nearly a third are concerned about the consequences of admitting errors.
The MDU survey of 418 doctors found 98% were familiar with the statutory duty of candour, which requires organisations to be open and honest with patients if they experience at least moderate harm after an incident. Nearly all respondents (99%) also reported responding to an incident in line with their legal and professional duties by apologising to patients, providing an explanation and putting things right if possible.
While 71% of doctors had no concerns about always being open and honest after an incident, 29% said they sometimes felt unable to do so because they were worried about the patient's reaction, being blamed or that they could face a claim for negligence.
The MDU called on legislators and policymakers to ensure no obstacles are put in the way of the open exchange of information after something goes wrong.
Dr Michael Devlin, head of professional standards and liaison at the MDU, said:
"The findings of our survey show that doctors understand the importance of being open and honest with patients when something goes wrong. Apologising meaningfully and explaining fully and promptly what has happened is vital for everyone involved in an incident. It is not an admission of legal liability for what has happened but an acknowledgement that something could have gone better. It can also help to improve patient safety.
"Our survey shows that a significant minority of doctors still harbour concerns about what might happen to them in the aftermath of telling the patient what went wrong. There remains much work to be done to ensure that an open and learning culture becomes the new norm in the NHS. Progress towards that goal is not as fast as we would wish and we call on those in leadership positions to make it happen."
The legal duty of candour has been in place in England for six years and in Scotland for three. A similar duty will come into force in Wales in 2022. The government in Northern Ireland is currently consulting on proposals to introduce a duty of candour under which individuals and organisations breaching the duty could be guilty of a criminal office.
Dr Devlin said this could be counterproductive, explaining, "If the proposals are fully adopted, Northern Ireland will be unique as the only UK country where the statutory duty applies to individuals as well as organisations, and where breach of the duty could attract criminal sanctions for clinicians.
"History has taught us that criminalising medical errors of judgement does not make patient care safer. We believe it would have a chilling effect on the profession and be counterproductive to achieving the open and honest culture needed to put patient safety at the front and centre of everything we do."
Other findings from the MDU survey included:
- 60% of doctors said the duty of candour had made them more likely to apologise and explain when something goes wrong in a patient's care. 39% said it hadn't changed the way they practice because they already followed the long-standing professional duty of candour required by the GMC.
- 72% had been involved in a patient safety incident although only 41% in incidents involving the duty of candour.
- In 80% of cases the response was accepted, in 6% there was a legal claim and in 2% there was either a complaint, GMC investigation or employer's investigation.
- The most common incidents involving the legal duty of candour were medication errors (45%), surgical problems (30%) and delayed diagnosis or referral (28%).
The MDU surveyed 418 doctors in August 2021, with a 6% response rate. Those responding included: specialty/core trainees (32%), consultants (22%), GPs (22%) and trust grade doctors (12%).
This page was correct at publication on 21/09/2021. Any guidance is intended as general guidance for members only. If you are a member and need specific advice relating to your own circumstances, please contact one of our advisers.