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Guidance urges nurses and midwives to be honest when things go wrong

The Nursing and Midwifery Council and General Medical Council have published guidance on creating a more open and transparent culture within health care

Nurse managers must ensure they protect staff who raise concerns from unfair criticism, detriment or dismissal, according to guidance published jointly by the nursing and medical regulators.

The Nursing and Midwifery Council (NMC) and General Medical Council (GMC) have published guidance on creating a more open and transparent culture within health care.

It says nurses and doctors must not try to prevent former or existing colleagues from raising concerns about patient safety, adding that managers should protect those who raise concerns from repercussions.

The duty of candour guidance, which has been produced to respond to Sir Robert Francis's recommendations following the failures at Mid Staffs, is designed to make sure doctors, nurses and midwives are working together to a common professional standard.

The regulators urge employers to create conditions that encourage doctors and nurses to admit mistakes. It says professionals need to work in an open and honest environment where they are able to learn from mistakes and feel comfortable reporting patient safety incidents.

Patients should receive a face-to-face explanation and apology from nurses and doctors when things go wrong, it says.

The guidance, which sets out the standards expected of all doctors and nurses in the UK, says staff should speak to a patient or those close to them as soon as they realise something has gone wrong with their care. They should apologise to the patient, explaining what happened, what can be done if they have suffered harm, and what will be done to prevent someone else being harmed in the future.

NMC chief executive Jackie Smith said: ‘We believe that the public’s health is best protected when the healthcare professionals who look after them work in an environment that openly supports them to speak to patients or those who care for them, when things have gone wrong. We can’t stop mistakes from happening entirely and we recognise that sometimes things go wrong. The test is how individuals and organisations respond to those instances, and the culture they build as a result.’

The guidance also states nurses and doctors should use their professional judgement about whether to inform patients about ‘near misses’, or incidents that could have resulted in harm but did not.

It adds that they should report errors at an early stage so lessons can be learned quickly and future patient safety incidents prevented.

In March, the NMC introduced the new Code for nurses and midwives, which states that nurses must exercise their duty of candour and raise concerns immediately whenever they come across situations that put their patients at risk.

In England, the professional duty of candour sits alongside a legal obligation on organisations to be open and transparent and similar measures are being introduced in Scotland, Wales and Northern Ireland.

Click here to read the guidance