New guidelines for nurses, midwives and doctors put honesty at the heart of healthcare

Patients can expect honest explanations from healthcare professionals if something goes wrong with their care under proposed new guidance from health regulators.

The Nursing and Midwifery Council (NMC) and the General Medical Council (GMC) have launched a public consultation on draft joint guidance which is designed to support nurses, midwives and doctors in fulfilling their professional duty to be open and honest about mistakes.

Modern healthcare is largely a team business and the aim is to set common standards which will apply to nurses, midwives and doctors when they deal with things that go wrong in patient care.

The proposals cover the need to learn from ‘near misses’ as well as when something goes wrong and a patient is harmed. There is also advice on apologising to patients and those close to them.

The draft guidance also calls on clinical leaders and employers to support nurses, midwives and doctors by creating cultures in the workplace that are open, honest, and where people learn from mistakes so that future patients are protected from harm.

Secretary of State for Health, Jeremy Hunt, who will be speaking at an event to mark the launch of the joint consultation this evening, said:

‘Transparency and honesty when things go wrong are powerful tools to improve patient safety, and part of the continued culture change we are determined to see in the NHS. These new guidelines will complement the statutory duty of candour on organisations and help make the NHS safer than ever before.’

Jackie Smith, the NMC’s Chief Executive and Registrar, said:

‘Healthcare professionals have a responsibility to be open and honest in the best interests of the people they care for. And we as regulators are responsible for protecting the public who use their services.

‘The duty of candour will enhance public protection as it will nurture an open and constructive learning environment. This in turn will support healthcare professionals who wish to raise concerns.

‘This guidance will help nurses, midwives and doctors – who work closely together – to uphold a common duty of candour and meet the responsibilities articulated in their professional standards.'

Niall Dickson, Chief Executive of the GMC said:

‘Patients deserve a clear and honest explanation if something has gone wrong with their care.

‘This is why, for the first time, we are collaborating on this new joint guidance. It will ensure that doctors, nurses and midwives are working to a common standard and will know exactly what their responsibilities are. But it will only be of any use if it makes sense in day-to-day practice and that is why we are now going to consult with patients and with doctors, nurses and midwives who deal with these issues on the clinical front line. We want to know if it is clear enough, covers everything it should and we would welcome ideas on how best to illustrate the guidance working in practice.’

‘We also want to send out a very clear message to employers and clinical leaders -none of this will work without an open and honest learning culture and we know from the Mid Staffordshire enquiry and from our own work with healthcare professionals that too often such a culture does not prevail. It remains one of the biggest challenges facing our healthcare system and a major impediment towards safe effective care.’

Last month the NMC, GMC and six other professional healthcare regulators in the UK published a joint statement, setting out their commitment to a duty of candour for healthcare professionals.

The new draft guidance follows Sir Robert Francis QC’s call for a more open and transparent culture within healthcare following the failures in patient care at Mid Staffordshire NHS Foundation Trust.

The consultation is open until 5 January 2015.  The NMC and the GMC aim to publish their new joint guidance in March 2015.


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