Duty of Candour
NHS providers have a statutory duty to inform and involve patients and their families in investigations where there has been severe harm under Regulation 20 of the Health and Social Care Act. In line with our policy, Duty of Candour (DoC) is overseen by the Patient Safety team and is attempted to be discharged for every serious incident, regardless of the level of harm caused. Further relevant cases are identified through a daily review of incidents reported. Contact is made with the patient, or a nominated representative, via telephone in the first instance. Following the primary telephone call, the conversation is summarised in a letter.
The content of our primary Duty of Candour conversations include:
- An introduction.
- An explanation of the incident identified.
- A sincere apology from us and condolences if the patient has sadly died.
- An explanation of the investigation process.
- An opportunity for the patient or nominated representative to ask any questions which they would like to be answered in the investigation.
- Establishment of preferred methods and frequency of involvement and communication throughout and after the investigation period.
There are often instances when it takes us longer to identify the individual most appropriate to discharge the Duty of Candour to. This is due to us not always having full patient or next of kin information. Our approaches to finding out this information include:
- Communication with GPs.
- Liaising with the patient safety specialists at the admitting hospital.
- Close working relationships with His Majesty’s Coroners.
Regulation 20 of the Health and Social Care acts requires the Duty of Candour to be discharged as soon as is reasonably practicable but always within 10 working days.
Analysis of our data demonstrates the following compliance with Duty of Candour for 2022/23 for serious incidents compared to the previous three years.
| 2019/20 | 2020/21 | 2021/22 | 2022/23 | |
|---|---|---|---|---|
| Number of cases initially requiring Duty of Candour | 51 | 40 | 161 | 277 |
| Duty of Candour discharged | 50* | 35* | 161 | 272* |
| Average timeframe for DoC to occur (working days) | 4.4 | 2.0 | 4.5 | 4.0 |
| Average timeframe for letter follow-up (working days) | 1.2 | 2.6 | 1.7 | 1.0 |
* For cases where Duty of Candour was not discharged, this is due to not being able to identify or make contact with next of kin despite best efforts to do so.
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