Medacs Healthcare

NOV 26/2014

BMA: Openness is key for better NHS care

A new consultation, launched by health secretary Jeremy Hunt, has sparked concerns from many leading bodies in the sector. One of these is the British Medical Association (BMA), which has said that the NHS needs to encourage a culture of openness to improve the service. As well as this, the BMA urged that patients should be shown the utmost respect at all times.

The comments came as a response to the public consultation on draft guidance by the General Medical Council (GMC) and Nursing and Midwifery Council about the duty of candour of medical professionals.

Focusing on two main areas, the consultation aims to analyse the way doctors, nurses and other healthcare professionals apologise to patients or those close to them, and report near misses to patients. 

It is hoped that this initiative will alleviate concerns that emerged after there were a number of reports of a fall in the standard of care at the Mid Staffordshire NHS Foundation Trust. A report was published in 2013, by Robert Francis QC, which called for the National Health Service to adopt a more open and transparent culture.

The new guidance has given medical professionals clear advice about how to approach certain situations, which can be challenging for both doctors and the patients themselves. If something goes wrong in the care journey, the care provider should speak to the affected patient as soon possible to give them clear information about any long or short-term consequences.

According to the updated advice, healthcare professionals should also apologise to the patient, and take care to find an appropriate and suitable place to deliver the news to them. It is hoped that this will create a better relationship between patients and medical staff, which would harbour more trust in difficult situations. Seeing doctors, nurses or midwives accept personal responsibility rather than a "general expression of regret" will encourage more openness in the health service.

In cases where the patient has not suffered any injury, illness, damage or harm, but a mistake has still been made, the care provider should use their professional judgement to decide whether or not the patient needs to be informed. The new guidance states that this may include getting advice from a more senior colleague.

Speaking about the issue, BMA council chair Mark Porter said the association strongly believed that the upmost respect should be given to patients at all times in a culture of openness and transparency. Dr Porter added that he is looking forward to the follow up review from Sir Robert on the reporting culture in the NHS.
Dr Porter said: "When things go wrong the vast majority of doctors already apologise at the earliest opportunity as this is a key professional duty. The GMC proposals to support that duty may well be helpful in this process.

"However, any suggestion of an enforced apology where there is a dispute over where fault lies would be inappropriate. 

"Research shows that most poor outcomes are due to system rather than individual failures. Apologies in these circumstances should be couched in those terms if we are to have a process that is truthful and appropriate."

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