Being Open
All of AvMA's experience of working with people affected by medical accidents tells us that what matters most to people after something has gone wrong is:
1. For everything possible to be done to put the matter right or minimise the effects of the error on the individual concerned, and
2. For there to be genuine openness and honesty about what happened.
We believe that the public at large need to be able to expect these things in order to have confidence in health care.
However, far too often there is defensiveness. Providers of health care either delude themselves that they have not been at fault or, worse still, we still occasionally come across deliberate obfuscation of the truth. A National Audit Office report in 2005 revealed that only 24% of NHS trusts routinely informed patients of a patient safety incident and, astonishingly, 6% admitted to never informing patients (A Safer Place for Patients, National Audit Office, 2005). In our experience, the vast majority of clinical negligence cases which are eventually settled in favour of the complainant had already been investigated internally with no admission of negligence and are often stubbornly defended. Even the chief medical officer of England agrees there is a 'culture of denial' which needs to be tackled in the NHS. (Safety First, 2007).
AvMA is calling for:
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organisation's implementation of the 'Being Open' guidance and training available from the National Patient Safety Agency to be assessed as part of the annual health check by the Healthcare Commission and corrective action to be taken against organisations who are seen not to be complying.
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the introduction of a legal 'Duty of Candour' - making it a legal offence for organisations or individuals to withold information about errors or omissions in patients care
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health professionals who admit / report their own involvement in a medical error to have their honesty taken into account as a strong mitigating factor in considering whether any action is neeed concerning them individually, but for health professional regulators to take a very strong line with health professionals who fail to live up to this fundamental ethical responsibility to be honest with patients (and their families. where appropriate)