Quality | 2009.09.27
NHS may have to own up to errors
The NHS would have to declare when staff mistakes injure or kill patients, under proposals being discussed on improving safety and cutting the soaring compensation bill for medical negligence.
The Department of Health is considering imposing a legally binding "duty of candour" on hospitals, surgeries and other healthcare providers, ensuring NHS managers admit to patients when an error has led to harm as well as explain exactly what has gone wrong and apologise.
The cost of settling legal claims against the NHS for clinical negligence rose to £807m last year, a rise of £146m on the year before, and the number of claims also increased, from 5,354 to 5,955.
Sir Liam Donaldson, the chief medical officer, supports a statutory duty of candour, as do the Commons health select committee and patient groups. Sir Bruce Keogh, the NHS\'s medical director, is understood to agree.
The health minister, Ann Keen, has told the campaign group Action Against Medical Accidents, which is working for the change, that it will get "full consideration" and has suggested the plan could be realised in 2011. Writing to the group\'s chief executive, Peter Walsh, she said: "I agree that a culture of openness and transparency is vital when things go wrong in the provision of care." But the registration regulations for health service providers, which the NHS watchdog, the Care Quality Commission (CQC), proposed to be in place in April 2010, were receiving final legal clearance before going to parliament, and that meant that changes could not be introduced "at this advanced stage".
However, opposition MPs could try to force ministers to make the change from 2010, when the rules are debated next month.
In a report, the health select committee said most NHS patients got safe, effective treatment, but not all care was as safe as it could be; some patients were "harmed, sometimes seriously, even fatally" and "tens of thousands of patients suffer unnecessary harm each year and there is a huge cost to the NHS". A Healthcare Commission inquiry found, for instance, that, from 2005-08 at Stafford hospital\'s A&E department about 400 more people died than would have been expected, because of poor standards of care.
The National Patient Safety Agency and NHS Litigation Authority have tried to get NHS staff to admit to errors. But medical defence groups still emphasise avoiding lawsuits rather than disclosure.
Walsh said that hard as it was, admitting errors was "the only thing to do ethically, morally and professionally". A legal duty of informing patients and next of kin would create "a huge watershed in the struggle for better patient safety and justice when patients have been harmed".
Cynthia Bower, CQC chief executive, said: "[Providers] that are straight with people build trust."
For more information, please visit
http://www.guardian.co.uk/society/2009/sep/27/nhs-health-safety-duty-candour
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