I was discussing the onset of Duty of Candour in Scotland with a colleague who works in operations within health and social care, and we both agreed that care providers deliver exceptional care daily, however sometimes, things go wrong. We all entered the profession with one commonality – to help, care and support people.
She said, “We always notify people when things go wrong and say sorry, why then, do we need this piece of legislation?” This is very true but the implementation of a National Duty of Candour will ensure a consistent approach across all health and social care providers. Research has shown that open-ness and discussing what has happened promptly, can help individuals cope better and build trust between people and the staff who care for them.
What is Duty of Candour?
The Duty of Candour Provisions in the Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill were given Royal Assent on 6th April 2016. The implementation date for the Duty of Candour Provisions is 1st April 2018. The overall purpose of the duty is to ensure that organisations are open, honest and supportive when there is an unexpected or unintended incident resulting in harm or death, as defined by the Act.
What will Organisations have to do?
Organisations (such as those providing health and social care, hospitals, independent contractors, and all regulated care services, except child minders) are required to follow a Duty of Candour procedure which includes notifying the person affected, apologising and offering a meeting to give an account of what happened.
The duty will also require the organisation to review each incident and consider the support available to those affected (both staff and the people we support).
Organisations have a requirement to publish an annual report on when the duty has been applied. This will include the number of incidents, how the organisation has implemented the duty and what learning and improvements have been put in place.
What Incident would Activate Duty of Candour?
The Duty of Candour procedure must be carried out by the responsible person as soon as practicable after becoming aware that an individual who has received a health, social care or social work service has been the subject of an unintended or unexpected incident, and in the reasonable opinion of a registered health professional has resulted in or could result in:
- Death of the person
- A permanent lessening of bodily, sensory, motor, physiologic or intellectual functions
- An increase in the person’s treatment
- Changes to the structure of the person’s body
- The shortening of the life expectancy of the person
- An impairment of the sensory, motor or intellectual functions of the person which has lasted, or is likely to last, for a continuous period of at least 28 days
- The person experiencing pain or psychological harm which has been, or is likely to be, experienced by the person for a continuous period of at least 28 days
- The person requiring treatment by a registered health professional to prevent –
- The death of the person, or
- Any injury to the person which, if left untreated, would lead to one or more of the outcomes mentioned above.
What Procedure Will We Need to Follow?
The stages of the procedure include:
- To notify the person affected (or family/relative where appropriate)
- To provide an apology
- To carry out a review into the circumstances leading to the incident
- To offer and arrange a meeting with the person affected and/or their family, where appropriate
- To provide the person affected with an account of the incident
- To provide information about further steps taken
- To make available, or provide information about, support to persons affected by the incident
- To notify the Care Inspectorate via e forms
- To prepare and publish an annual report on the Duty of Candour
How Can I Obtain Training?
There is an excellent e learning resource provided by NES and organisations should support and facilitate their staff to complete. It can be found here
We at QCS have developed a comprehensive Duty of Candour policy with accompanying documents to assist you and your staff team.
