What is the Duty of Candour?

The Duty of Candour is a new obligation that all providers of Healthcare Services, registered with the Care Quality Commission (CQC) must comply with. Essentially, the duty requires you to be open and honest when a notifiable incident occurs. To find out more about the background to the Duty of Candour, please visit the CQC website http://www.cqc.org.uk/content/regulation-20-duty-candour.

What is a notifiable incident?

A notifiable incident is defined as any unintended/unexpected incident that occurs in respect of a service user during the provision of a regulated activity that, in the reasonable opinion of a healthcare professional, appears to have resulted in:

  • The death of a service user, where the death relates directly to the incident rather than to the natural course of the service user’s illness or underlying condition, or
  • Severe harm, moderate harm or prolonged physical harm to the service user.

How the Duty of Candour can affect your insurance policy.

The regulations require that when things go wrong, the care provider should explain what has happened and express sympathy and regret.

Insurers typically will require notification of incidents that could give rise to a claim without delay. It would be good practice to notify us and your insurer before an apology is issued so that we can assist you with this as at all times we have to ensure that the insurers’ position in a possible future claim is not prejudiced.

Please be aware that insurers require you not to admit liability at any point whilst in communication with a service user or their family.  Please be aware that an admission of regret and sorrow (as required under the Duty of Candour) is not an admission of liability if approached correctly.

Recommendations

  • Notify your broker when a notifiable incident occurs, so they can in turn notify your insurer.
  • When a notifiable incident has occurred and you are making attempts to contact the service user’s family, keep a record of these attempts. You need to ensure that you do not get criticised for not making contact. As a guide we would recommend a minimum of 3 attempts.
  • Have a Duty of Candour pack in place which includes policies and procedures demonstrating the organisation’s commitment to openness and transparency.
  • Ensure all staff are aware of the Duty and that they understand what constitutes a notifiable incident and what they need to do following the occurrence of a notifiable incident. Ensure staff have all received training and that this training has been recorded.
  • Nominate 1 or 2 designated members of staff who are responsible for speaking to the family members after a notifiable incident has occurred.
  • Train nominated staff to deal with family liason and ensure that they are aware of insurance policy requirements
  • Have a set form of words used for the apology letter and adapt to the specific circumstances of each incident.
  • Consider the structure of investigation reports so as not to contravene policy conditions on admissions of liability and, if in doubt, refer to your insurers before issue.
  • Seek assistance from insurers in difficult or challenging scenarios when issuing initial letters or investigations.
  • Consider the specific guidance that has been issued by your insurers, if issued.

This publication is meant for guidance only and if you have any queries, please contact any member of the team on 01904 784141.

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