1. PROCESS STATEMENT
The effect on patients, relatives, carers (relevant person(s)) and staff, when things go wrong, can be devastating. ‘Being Open- a duty to be candid’ outlines the principles that BrisDoc staff should use when communicating with relevant person(s) following a patient safety incident, complaint or claim where a patient was harmed. The term “relevant person” is now used with respect to the person(s) with whom duty of candour communications are held. ‘Being Open- a duty to be candid’ supports a culture of openness, honesty and transparency, and includes apologising and explaining what happened after reflection and with knowledge of all the facts. This policy incorporates Regulation 20 ‘Duty of Candour’, (Health and Social Care Act 2008 (Regulated Activities) Regulations 2014) and reinforces the legal obligation to be open and honest in the event of an incident where patient harm has occurred. Although a rare event, when a clinically related incident occurs in which a patient suffers harm or dies, entering into an open dialogue with the patient, their carers or their representatives can significantly reduce the impact, stress and worry for all concerned. An essential part of handling patient related incidents effectively is following an established procedure of honest and open communication with them, their carers and/or their families. Staff providing health care have a legal and professional duty of candour to be open and transparent with patients when things go wrong. In line with BrisDoc’s Incident Policy, staff must report incidents, and as part of having an “open, strong culture for patient and staff safety” BrisDoc will ensure that staff are fully supported throughout any investigation and resolution. It is also the case that patients, family and staff can experience significant distress with “lesser impact” issues. The statutory duty of candour applies to notifiable safety incidents as set out in Regulation 20 (appendix 1). However, the importance of being open, honest and using sensitive communication is high irrespective of the “weight” of the case. Openness and honesty at the point of an incident occurring can help prevent all such events becoming complaints or litigation claims. This policy addresses BrisDoc’s response to the national best practice guidance regarding Being Open and legal duty of candour when a patient safety incident occurs, using the 10 principles underpinning ‘Being Open’ as supported by the National Patient Safety Agency (NPSA). These are (see appendix 2 for a full description):
The effects of harming a patient can have devastating emotional and physical consequences for relevant person(s). It can also be distressing for the professionals involved. Being open and honest about what happened; discussing the incident/complaint/potential claim fully, openly and compassionately can help the relevant person(s) cope better with the consequences of harm, whether potential or actual, in managing the event, and also in coping in the longer term. In addition, being open and candid when things go wrong ensures that the investigation gets to the root cause of the event and promotes individual and organisational learning. The purpose of this policy is to set out BrisDoc’s standards and expectations for having an open and candid conversation in accordance with BrisDoc’s values for patient, workforce and quality care. These standards are based on the guidance of the NPSA, and are intended to create an environment where patients, their representatives and staff feel supported, have the confidence to act in accordance with their duty, and for ensuring that all communications with relevant people are open, honest and occur as soon as possible after an event.