NEXT Being Open: Duty of Candour 2016 This overview is for non-clinical staff. If you are clinical staff, please complete the Overview for clinical staff However, if you are a manager, team lead or above, you should complete the detailed version. NEXT

Being Open: Duty of Candour 2016 This basic overview is for all non clinical staff. Approx. 15 mins START

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Being Open: Duty of Candour 2016 Navigation Toolbar

Introduction I I Francis Report recommendations: 181: statutory obligation to observe a duty of candour on healthcare providers who believe or suspect that treatment or care provided by it to a patient has caused death or serious injury to inform that patient…as soon as practicable and to provide such information as the patient may reasonably request. 182: statutory duty on all directors of healthcare organisations to be truthful in any information given to a healthcare regulator or commissioner, either personally or on behalf of the organisation where given in compliance of a statutory obligation to provide it. “Being Open” / “Duty of Candour” involves: Acknowledging, apologising and explaining when things go wrong. Conducting a thorough investigation into any incident and reassurance that lesson have been learnt Providing support for those involved I “Promoting a culture of being open in all communication is therefore a prerequisite to providing high quality healthcare and improving patient safety.” SEPT Policy on communication patient safety events “Being Open”. I Navigation Toolbar

Course bjectives To understand the principles of ‘Being Open’. To have an overview of the ‘Being Open’ process and the benefits of this. Navigation Toolbar

Question ‘Being Open’ involves: Approaching, acknowledging and explaining Acknowledging, explaining, deterring Acknowledging, apologising and explaining Approaching, blaming, explaining Navigation Toolbar

is a request for compensation. Definitions Duty of candour Legal requirement for all clinicians, managers and healthcare staff to inform patient/relatives of any actions which have resulted in moderate or severe harm or death. Patient safety event is any unintended or unexpected incident that could have or did lead to harm for one or more patients receiving NHS funded healthcare. Serious incident (SI) is a serious incident or near miss which may require further investigation including those reported via Safeguarding Children and Safeguarding Adults procedures. Definitions Complaint is an expression of dissatisfaction received by the Trust verbally or in writing either directly from or on behalf of existing or former service users, carers, relatives, visitors or other users of Trust facilities Root cause analysis is a structured approach and reporting system for investigations of patient safety events or incidents. Claim is a request for compensation. Navigation Toolbar

Who has responsibility? Directors and Senior Management will have an overarching responsibility within their own service area for monitoring and implementation of the policy, but all staff have a responsibility to ensure they follow the principles. Managers and other Persons in Charge / Team Leaders / Ward Managers and Senior Sisters, where identified as the nominated Contact point have responsibility to ensure the procedures and principles of the ‘Being Open’ policy are followed and monitored. Individuals have a responsibility to ensure that the principles contained within the ‘Being Open’ policy and associated guidelines are followed; in that they: Must ensure that they report all patient safety events, complaints or claims to their line manager immediately. Have responsibility to ensure as part of continuing professional development they acquire, maintain and disseminate knowledge and skills to carry out where required the principles of “Being Open”. Through, clinical supervision and post event reviews, can expect to receive support tailored to their individual need. I Navigation Toolbar

Ten key Principles P R I N C I P L E S Acknowledgement Truthfulness, Timeliness and Clarity of Communication Apology Recognising Patient and Carer Expectations Professional Support Risk Management and Systems Improvement Multi-disciplinary Responsibility (MDT) Clinical Governance Confidentiality Continuity of Care Navigation Toolbar

Of the ten key principles, which is most important? Question Of the ten key principles, which is most important? Confidentiality All of them Principles 1-5 Apology Navigation Toolbar

Pr cess Overview Incident detection or recognition Provide written records of all ‘Being Open’ discussions Record investigation and analysis related to incident Documentation Incident detection or recognition Preliminary team discussion Initial ‘Being Open’ discussion Written communication Follow up discussions Process completion Detection and notification through appropriate systems Initial assessment Verbal and written apology Written communication must follow the initial discussion Provide update on known facts at regular intervals Discuss findings of investigation and analysis Provide known facts to date Inform on continuity of care Establish timeline Offer practical and emotional support Share summary with relevant people This must be provided within 10 working days of the incident Prompt and appropriate clinical care to prevent further harm Respond to queries Monitor how action plan is implemented Identify next steps for keeping informed Choose who will lead communication Communicate learning with staff NEXT NEXT NEXT NEXT NEXT Navigation Toolbar

Documenting and Recording All communication surrounding any incident must be recorded within appropriate documentation using Trust guidance. This will include service user case notes, ward report book, complaint and claim files and incident report forms. It is important to record discussions with the patient, their family and carers. The required patient safety event documentation includes: A copy of the relevant medical information Incident reports Records of the investigation and analysis process Navigation Toolbar

Healthcare organisations & teams Benefits of being open Healthcare organisations & teams Patients A reputation of respect and trust for the organisation and/or team Receive a meaningful apology and explanation when things go wrong Know that lessons learned from incidents will help prevent them from happening again Feel their concerns and distress have been acknowledged Reinforces a culture of openness and gives staff confidence in how to communicate effectively when things go wrong Reduce the trauma felt when things go wrong Have greater respect and trust for the organisation A reputation for supporting staff when things go wrong, with staff feeling supported in apologising and explaining to patients, their families and carers Reassured that the organisation will learn lessons to prevent harm happening to someone else Improves the patient experience and satisfaction with the organisation Navigation Toolbar

What happens if we get this wrong? Legal Duty of Candour requires openness and specifically requires the notification process to take place in a particular way If not then the CQC may take regulatory action for breach of a fundamental standard In extreme cases the Trust could be prosecuted under the criminal law and fined Individuals who fail to comply may face disciplinary action from their employer or regulatory action from their professional body Navigation Toolbar

serious.incident@sept.nhs.uk 01268 407739 Associated Documents The Trusts documents of Policy and Procedural Guidance associated with this policy are: CP2 and CPG2 Complaints Policy and Guidelines. CP10 Negligence and Insurance Claims Policy. Adverse Incident Reporting including Serious Incident Policy CP3 Clinical Risk Assessment and Management CLP28 CPG53 (Procedure for Staff on Dealing with Issues of Concern about Health Care Matters) CP53 (Policy for Staff on Whistle Blowing – Public Concern about Health Care Matters) Mental Capacity Act 2005 Policy MCP01 These documents can be found on the SEPT intranet site and under the ‘Policies’ tab. If you have questions regarding this and/or require further guidance, please contact the Serious Incident team: serious.incident@sept.nhs.uk 01268 407739 Navigation Toolbar

IT Training IT training is available in: Word Excel Use a computer?   Make sure you use I.T. well! IT Training IT training is available in: Word Excel PowerPoint Publisher Outlook Explorer General skills For information on locations, dates, times, availability and for any other questions please contact: Jay Thornton : james.thornton@sept.nhs.uk : 01268 568068 Navigation Toolbar

Review of Objective(s) Before completing the test, please ensure you have acquired the relevant knowledge against the modules objective(s) below: “To understand the principles of ‘Being Open’ and have an overview of the ‘Being Open’ process and the benefits of this.” If not, please take this opportunity to revisit the presentation content. Navigation Toolbar

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