The Royal College of Physicians' (RCP's) response to the Professional Standards Authority’s consultation on the professional duty of candour.
It has been reported to the Royal College of Physicians that there have been improvements in transparency, openness and approaches to candour since 2014. Anecdotally, clinicians are more aware of the need to be candid and inform patients when medical errors have occurred. However, in terms of overall progress in transparency, only 31% of doctors surveyed for the RCP report NHS Reality Check: Update 2018 think their ‘freedom to speak up guardian’ has improved the culture of transparency and raising concernsi.
The RCP is aware that levels of candour can vary across the sector. There is still room for improvement through leadership, a culture of openness and support for learning. The Health Service Safety Investigations Bill could be a way to further improve the duty of candour in future.
There is support for the duty of candour and recognition of the role it plays in delivering high-quality care, however some scepticism remains, that the duty is being adhered to everywhere and there is also concern that there are not adequate system processes in place to learn and prevent similar errors from occurring in future.
Through this consultation concerns have also been raised about the impact of recent high-profile cases on attitudes towards candour and the negative impact on doctors’ willingness to be open about mistakes, cannot be underestimated. It is important to ensure that a culture of learning and improvement, as opposed to a culture of blame, is fostered and further clarity about accountability and process for candour is needed.
As noted in the consultation, this is difficult to measure and there seems to be some variability in the extent to which attitudes to the duty of candour have changed across NHS trusts. It is clear that we, as a sector, must do more to promote a culture of candour.
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