Duty of Candour
The Athena Herd Foundation Accredited Practitioner Register™ (“The Register”) seeks to understand and/or confirm:
- That the practitioner, organisation, or training centre and/or recognised training centre that was providing the services act in an open, transparent and accountable manner in relation to the support, care for or treatment the service user or client?
- That if something went wrong or a mistake was made which resulted in death or severe harm to the service user, was the service user (and their family/carers) informed? Was reasonable support provided and an apology made?
What is the “The Duty of Candour”?
The contractual Duty of Candour was introduced in 2013 by NHS England as part of the ‘Being Open’ Framework and as such is similarly recognised by other organisations proving public health services. In 2014 it became a legal duty for which a failure to be candid on behalf of NHS organisations would be treated as a crime.
In 2015, this was extended to apply to all health service bodies including the NHS, adult social care, primary medical and dental care, and independent healthcare providers. As a result, if any of these agencies fails to notify and apologise to patients for incidents that have caused them harm, it is treated as a criminal offence. The Care Quality Commission (CQC) is responsible for regulating whether organisations are adhering to the duty.
The Register recognises that registrants need to comply with these conditions in working with their service users.
Definition of Duty of Candour
Athena Herd Foundation expects that practitioners must act in an open and transparent way throughout all aspects of care and treatment provided to service users.
As soon as reasonably practicable after becoming aware that a notifiable safety incident has occurred the practitioner must—
(a) notify the relevant service user that the incident has occurred, and
(b) provide reasonable support to the relevant service user in relation to the incident, including when giving such notification.
(This is drafted in line with Section 20, The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014)
Key Principles and Application
Athena Herd Foundation recognises three principles within the Duty of Candour and as such considers as them essential elements of health, care and wellbeing provision. These are: openness, transparency and candour. We understand these as follows:
- Openness – concerns and complaints can be raised freely without fear and that any questions asked or challenges raised will be answered
- Transparency – information about the truth about performance and outcomes to be shared with practitioners, service users, the public and regulators
- Candour – any service user harmed by the provision of a service is informed of the fact and an appropriate remedy offered, regardless of whether a complaint has been made or a question asked about it.
The Athena Herd Foundation Compliments and Complaints Policy provides the framework for service users to report any arising breaches under this Duty of Candour and to have these issues addressed. Dependent upon the outcome of this process the complaint would be escalated to the Athena Malpractice and Maladministration Policy, and where appropriate sanctions or SMART action plans imposed in line with the Athena Herd Foundation Sanctions Policy.
The Register stipulates that Practitioners should have their own complaints processes in place in line with that outlined herein. These policies should be exhausted before any escalation to Athena Herd Foundation Compliments and Complaints Policy.
What should be reported under the Duty of Candour?
Duty of Candour expects that any ‘notifiable patient safety incident’ should be reported. This is any unintended or unexpected incident if it causes, or is expected to cause:
- Death or severe harm, if it relates to the incident rather than the disease e.g. permanent lessening of bodily, sensory, motor, physiological or intellectual functions, including removal of the wrong limb or organ or brain damage
- Moderate harm – harm that is significant in that it requires a moderate increase in treatment and harm that is significant but not necessarily permanent
- Prolonged psychological harm for a minimum of 28 continuous days
All of the above as well as incidents that relate to a near miss or result in low harm are not relevant to the Duty of Candour, will be covered and supported under the Athena Health and Safety Policy.
Service users should be told as soon as is reasonably practical and must be given reasonable and appropriate support. Further inquiries can be instigated by practitioners and their organisations, and service users should be told about these too. A written note must be provided including notes of any discussion, and copies of all correspondence must be kept.
Individual practitioners will be, or organisations and/or training centre and/or recognised training centre shall have a lead person, responsible for the duty of candour and should have their own policies and procedures including an obligation to tell the Accredited Practitioner Register when an incident occurs.
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