NHS ‘cover-up culture’ under spotlight in new review
Effectiveness of statutory duty of candour to be checked amid concerns about a lack of openness and transparency
The government has announced a review of the legal duty for health and care services to admit to mistakes following concerns about a ‘cover-up culture’ in the NHS.
The review will look at the effectiveness of the statutory duty of candour, which means patients and families have the right to a full explanation and apology when things go wrong.
The move comes amid concern about a general lack of openness and transparency – as exposed by the Lucy Letby case and other investigations into serious care failings including the Martha Mills case – which can mean patient safety fears are ignored, whistleblowers are victimised and families face lengthy battles to get to the truth.
The duty of candour has been in place for NHS trusts and foundation trusts since 2014 and for all other providers regulated by the Care Quality Commission since 2015.
Organisations must say when there’s a serious safety incident, apologise and explain what happened
It requires organisations to tell people face-to-face when there has been a serious safety incident, and to apologise and explain what happened. However, families often report being fobbed off or ignored when they ask questions or raise concerns about the quality of care when a loved one has died or suffered severe harm.
The review, which will be undertaken by the Department for Health and Social Care, is set to get under way in the New Year, with findings due to be published in the Spring.
Announcing the review, health minister Maria Caulfield said: ‘Since its introduction there has been variation in how the duty has been applied in some settings.
‘To that effect, the review will look at the operation and enforcement of the existing duty, with a focus on delivering recommendations that can improve its application.’
Patients and their families deserve better, says health service ombudsman
The review was welcomed by parliamentary and health service ombudsman Rob Behrens, who has previously raised concerns about a wider cover-up culture in the NHS.
Mr Behrens said: ‘Despite it being a statutory duty to be open and honest when things go wrong with a patient’s case, I know from the cases we investigate that this doesn’t always happen. Patients and their families deserve better.’
The review will look at the duty of candour only as it applies to organisations and will not cover the professional duty of candour that individual nurses and others are expected to uphold.
Review of progress on patient safety goals
Healthcare experts will rate the government’s progress on creating a culture of safety and whistleblowing as part of a new independent review in the wake of the Lucy Letby case.
An expert panel of the House of Commons Health and Social Care Committee will examine five recommendations made by a range of public inquiries and safety reviews and give each a Care Quality Commission-style rating from ‘inadequate’ to ‘outstanding’.
The recommendations under scrutiny also cover staff training and maternity care and leadership.
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