How did the ‘Duty of Candour’ legislation become a legal requirement in the UK?

The world of healthcare is changing, with new frameworks, regulations and challenges. Having suitable systems put in place to help healthcare professionals prioritise the safety of patients and staff members is of the utmost importance. 

Below, the experts on behalf of healthcare quality & compliance software providers Radar Healthcare highlight how recently passed legislation will help to provide more openness and transparency within healthcare services, while also ensuring accountability and ongoing continual improvements regarding avoidable incidents.

“Since November 2022, all public and private hospitals are required to: 

• Apologise to anyone seriously harmed while receiving care
• Explain what went wrong
• Describe what action will be taken and improvements put in place to reduce the risk of an incident occurring again 

“The above is referred to as the Duty of Candour, and is a regulation that originally came into force in England at the end of 2014, alongside a renewed commitment on the part of health professional regulators to promote and regulate health professionals’ professional duty of candour. The regulation enforces all healthcare professionals to remain open and transparent with people receiving treatment and services. The legislation applies to all health and social care providers that are regulated by the CQC. 

“According to the General Medical Council, doctors must inform a patient (or their family member, carer or advocate) when something has gone wrong in their treatment. An apology, a suitable remedy, or support must be offered, as well as a clear explanation of the short and long-term effects of what has happened. Healthcare professionals must also be open and honest with their regulators, and raise any concerns where they feel appropriate. 

“The CQC outlines that the term ‘Notifiable safety incident’ should be used in the duty of candour regulation. A notifiable safety incident must meet all 3 of the following criteria: 

1. The incident must have been intended or unexpected.
2. The incident must have occurred during the provision of an activity that the CQC regulates.
3. In the reasonable opinion of a healthcare professional, the incident has, or might, result in death, or severe or moderate harm to the person receiving care. (This element varies slightly depending on the type of provider.)

“If any of the above criteria aren’t met, it’s not considered a ‘notifiable safety incident’, but the overarching duty of candour, to be open and transparent, will always apply.

“Here at Radar Healthcare, we have a longstanding partnership with AvMA (Actions against Medical Accidents) who campaigned tirelessly for the Duty of Candour legislation for two decades. On our What The HealthTech? podcast, we have recently released a two part podcast speaking with the CEO of AvMA focused on the work it does in improving patient welfare, and the part it plays in supporting those affected, their families and the staff involved in incidents. 

PSIRF Framework

“Like the duty of candour legislation, the implementation of PSIRF (Patient Safety Incident Response Framework) is a vital part of the NHS Patient Safety Strategy, which aims to continually improve and build on the foundations of safer culture and systems. 

“PSIRF is mandatory for any services under the NHS Standard Contract, including acute, ambulance, mental health, community healthcare, maternity and specialised services. The framework focuses on creating an open and transparent reporting culture, with the four main aims covering: 

1. Compassionate engagement and involvement of those affected by patient safety incidents.
2. Application of a range of system-based approaches to learning from patient safety incidents.
3. Considered and proportionate responses to patient safety incidents.
4. Supportive oversight focused on strengthening response system functioning and improvement.

“As our risk, quality and compliance software here at Radar Healthcare has been specifically designed with patient safety in mind, our LFPSE compliant and AI-driven systems help healthcare workers: configure the right processes to include feedback and actions, tailor these to all learning response methods, create the right workflows for improvement plans, give oversight of trends and encourage continuous improvement.”