The NHS is facing a quality of care crisis which will only get worse until genuine efforts are made by NHS Trusts to embrace the duty of candour and improve staffing levels.
In a speech today, Health Secretary Jeremy Hunt will announce a new ‘duty of candour’ requirement meaning NHS hospitals will be legally required to disclose information about errors made in patient care.
The launch of a new ‘duty of candour’ was one of the key recommendations made in the Francis Report, following the revelation of widespread failings at the Stafford Hospital. The aim is to reduce the number of cases of avoidable harm caused to NHS patients by medical errors.
While the vast majority of doctors and nurses will have the best interests of patients at heart, there is no hiding from the fact that their working conditions are extremely difficult. A combination of budget cuts (leading to understaffed wards and poor and inadequate training and supervision), a strong emphasis on meeting targets and managerial constraints have made it extremely difficult to deliver safe, dignified and compassionate care. This is being compounded by a reluctance on the part of some NHS Trusts to embrace the duty of candour.
In his examination of the quality of care at Stafford Hospital in 2005 to 2009, Robert Francis QC highlighted the need to address a “culture of fear” in the NHS and called for a duty of openness and candour. He stressed that it was not acceptable to suppress complaints or attempt to sweep sub-standard practice under the carpet.
Shocking events that have recently come to light concerning Kettering General Hospital highlight the need for the duty of candour to be embraced by staff at all levels. A 17 year old girl, Victoria Harrison bled to death following surgery to remove an appendix in 2012. An enquiry revealed that 43 errors had been made in her care, but hospital bosses refused to release details. Details only came to light following a request made by BBC journalists under the Freedom of Information Act. It is difficult to see how hospitals can learn from such tragic events when details of significant failings are suppressed.
To make significant improvements to the quality of care and to prevent more unnecessary fatal and devastating events such as Victoria’s death and the many deaths associated with substandard care at Stafford Hospital, it is vital that healthcare professionals at all levels have the freedom to speak openly and honestly about patient safety without fear of recrimination. Indeed, it is only by being open and honest about concerns over patient care that problems will be properly identified and tackled, and standards improved. Given that one of the issues that healthcare workers are likely to speak out above is understaffing on wards, this is an issue that needs to be urgently addressed. It is difficult to see how safe and compassionate care can be delivered to patients on wards where staff are spread to thinly.