Thus, if the audit concludes that there was a process error or if the interpretation performance fell below a set standard and this contributed to serious or moderate harm to the person being examined, then something went wrong. This should then be recorded as a reportable security incident and the duty of transparency should be respected, including apologising. We have created a short animation to help those who work in health and social services to better understand the similarities and differences that exist between the professional and legal obligations of openness. The 8-minute animation also provides tips on how to fill them out effectively. Regulators of some health professions monitor the professional duty of openness. The professional duty of openness is a professional responsibility to deal openly and honestly with patients and families when something wrong with their treatment or care causes or has the potential to cause harm or suffering. This includes apologizing and taking steps to fix things when possible. It is always the right thing to do and not an admission of responsibility. The professional duty of opening states that all health professionals have a duty to inform the user of the service or the family, lawyer or caregiver if something goes wrong. It differs from the legal obligation to open in that it is regulated by certain health professions such as the General Medical Council (GMC), the Nursing and Midwifery Council (NMC) and the General Dental Council (GDC). The obligation to write the opening is important because it repeats what has already been said and gives the service user, family or caregiver a point of reference that they can check and re-read if they are not sure of anything.
It differs from the professional obligation to open in that it contains specific requirements for situations known as reportable security incidents. These are unintentional and unexpected incidents that occurred in the course of a regulated activity and that resulted or could result in serious harm or death. If a reportable security incident occurs, the fulfilment of the professional obligation to open is not in itself sufficient to meet the requirements of the legal obligation to open. It is important to note that nurses are subject to both the professional duty of openness and the legal duty of openness. The concept of being open and honest when something goes wrong during treatment or care has long been awaited by professionals, but it has not been specifically applied or regulated. Therefore, the CQC introduced the duty of openness as a regulation that came into force in 2014 for NHS bodies and all other bodies regulated by the CQC in 2015. This ensures that every nurse fulfills the duty of openness to the same standards. If, as a healthcare worker, you have been involved in a reportable safety incident, you are responsible for apologizing. The purpose of the duty of openness is to share all information openly, with compassion and support, because the person who has been hurt has the right to understand what happened to him. The duty of openness is not to try to blame; Therefore, apologies should be simple and direct expressions of grief and regret. This publication is available from www.gov.uk/government/publications/nhs-screening-programmes-duty-of-candour/duty-of-candour The legal requirement to be open is set out in Regulation 20 of the Health and Welfare (Regulated Activities) Act 2014 Regulations 2014. It imposes a primary legal obligation on health and social service providers to be open and transparent about the people who use the services and their families with regard to their treatment or care.
It is monitored by the Commission de la qualité des soins or CQC. Following these points will help you effectively fulfill the professional and legal obligations of openness. In January 2014, David Behan, Executive Director of the Quality of Care Commission, threw his weight behind a broad definition of the legal obligation to be open recommended by the Francis report. [5] Originally, the government intended to limit the obligation to cases of «serious harm» – where a patient had been killed or permanently disabled, as a more comprehensive reporting requirement could flood organizations with unnecessary bureaucracy. The CQC estimates that there are approximately 11,000 incidents of serious harm per year and up to 100,000 incidents of serious harm, although there may be significant cases in reporting both. The charity Action Against Medical Accidents has advocated for a broad definition[6] and Behan has made it clear that he supports it. Failure to comply with the principles of professional openness may result in disciplinary action. Death – Staff provided first aid to a service user for a small scratch on his arm. The employee inspected the scratch with latex gloves because he knew nothing about the service user`s latex allergy. The user of the service suffered anaphylactic shock and was hospitalized. The service user did not perform a full restore and died. This is considered a reportable security event, so all the steps described in the transparency obligation must be carried out.
The duty to be open is an extremely important element in providing quality care. Service users and their loved ones deserve to know the details about the care they receive and the truth about any incident that occurs. The duty of openness is also an important part of providing person-centred care by respecting service users, being honest and involving them in their care. Dealing openly and transparently with patients and their families when treatment or care goes wrong is the key to a good duty to maintain openness. The legal obligation to open was introduced after the professional obligation to open, but also aims to ensure that service providers are open and transparent. The legal obligation to open covers all service providers that are registered and regulated by the CQC. Activist Will Powell [4] campaigned for NHS managers and doctors to have a «formal duty to be open» when dealing with complaints of negligence or poor standards of care in NHS hospitals. Basically, it means being honest when something goes wrong – we supported the introduction of a legal duty of openness for organisations providing healthcare. We believe there are immense benefits to caring for and treating people in the health and care system if it is open, transparent and honest. Professionals also have a duty to open according to the codes established by their professional regulator. Download our latest report, which assesses the progress made by professional regulatory bodies in integrating the duty of professionals to be open to patients.