1. 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.
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2. Being Open: Duty of Candour 2016
This basic overview is for all non clinical staff.
Approx. 15 mins
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7. Being Open: Duty of Candour 2016
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8. 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
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9. Course bjectives To understand the principles of ‘Being Open’.
To have an overview of the ‘Being Open’ process and the benefits of this.
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10. Question ‘Being Open’ involves:
Approaching, acknowledging and explaining
Acknowledging, explaining, deterring
Acknowledging, apologising and explaining
Approaching, blaming, explaining
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11. 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.
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12. 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
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13. 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
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14. 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
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15. 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
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16. 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
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17. 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
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18. 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
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19. 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:
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20. IT Training IT training is available in: Word Excel
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IT training is available in:
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General skills
For information on locations, dates, times, availability
and for any other questions please contact:
Jay Thornton : :
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21. 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.
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