Doctors in Scotland advised on new duty of candour by MDU

From 1 April 2018, a statutory duty of candour will be in place in Scotland requiring healthcare organisations to be open and honest with patients when something goes wrong and to offer them an apology, explains the Medical Defence Union (MDU).

The duty, which will apply widely across health and social care organisations including NHS Boards, NHS hospitals, private hospitals and clinics, GP services and dental surgeries, places a requirement upon them to be open and honest, apologise and try to learn from things that have gone wrong. In order to improve the quality of service to patients, there is also a requirement to share learning from incidents.

The new duty of candour procedure is technical and complex, so the MDU has issued guidance to its members.

Dr Michael Devlin, MDU head of professional standards and liaison, says:

'Doctors will have an important role to play in helping their organisations meet their obligations under the new statutory duty of candour. Doctors will remain at the heart of ensuring patients are told when something goes wrong. But they need to know that the new statutory duty applies in some, but not all circumstances, unlike their ethical duty which is set out by the GMC.

'For very many years we have advised our members to let patients know as soon as something goes wrong and to apologise if appropriate, and explain what has happened and what they are going to do to put it right. The new duty is complex in how it will operate and doctors may wish to find out if there organisations are offering training to help implement the procedures.

'For example, there are legally defined thresholds above which the duty will apply. These include unexpected or unintended incidents that lead to a patient's death, or result in severe harm or other specified types of harm, not due to the natural progression of the disease. The duty requires that the decision about whether a particular incident meets the threshold is made by a doctor or other healthcare professional not involved in the incident.

'There may be some confusion within organisations and among patients, carers and relatives about the sort of incident that will be covered by the statutory duty, and even dispute about the extent of that duty. As the process requires an independent healthcare professional to determine whether the threshold is met, doctors are likely to become involved in giving such opinions. It will require them to be objective and impartial and to be prepared to explain or justify their opinion.

'The regulations recognise that staff involved in major patient safety incidents, where the duty is likely to apply, may require support themselves and that organisations must ensure staff know where to find it.

'Doctors will need to continue to inform patients in the usual way any time anything goes wrong, in accordance with GMC guidance.'

This guidance was correct at publication 31/03/2018. It 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.

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