Requires improvement

When AvMA successfully campaigned for a statutory duty of candour in 2014, it marked an historic advance in patients’ rights and patient safety. So it is concerning to find that regulation of the duty by the Care Quality Commission (CQC) is not as thorough as we would hope.

We undertook our own independent research and found that the CQC “requires improvement” in how it regulates the statutory duty of candour. We found it doesn’t record how many individual allegations it receives and has no system ensuring allegations are dealt with. Inspections are inconsistent and the CQC does not publicise any enforcement action it takes.

Although there have been significant improvements since our previous report in 2016, we were still concerned and made a series of recommendations including:

  • Developing a more robust framework for inspections to assist with assessing compliance with the duty of candour
  • Improving how it deals with reports received alleging individual breaches of the duty of candour
  • Reporting consistently on the duty of candour (and the other fundamental standards)
  • Publicising any regulatory action taken more proactively
  • Ensuring consistently high quality training on duty of candour is rolled out across England.

“How can any inspection of an NHS trust ever fail to look at duty of candour (a ‘fundamental standard’) at all?” asked our chief executive Peter Walsh. “How can identified failures to comply fully not result in a recommendation, let alone regulatory action? How can the regulator still have no system in place to assess allegations of breaches of the duty or even record the number of them? In the CQC’s own terminology, it still “Requires Improvement” itself when it comes to the duty of candour. Our recommendations, if followed, will deliver that.”