Contractual demand will reveal NHS patient safety failures

10 December 2012

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10 December 2012 | Anna Reynolds

A contractual clause requiring NHS organisations to tell patients if their safety has been compromised will be inserted into commissioning contracts from April 2013.

Although all NHS organisations are expected to be open about failures in patient care, there is currently no contractual duty to hold them to account when this does not happen.

The NHS Commissioning Board is yet to finalise details of the requirement, but the plan is that if NHS organisations fail to comply with the contract, their chief executives will have to apologise in writing to the patient and report the breach to the Care Quality Commission. Action plans to prevent the breach recurring could also be required.

Health minister Dr Dan Poulter said in a statement: “Patients place great faith in the NHS organisations that treat them and they, in turn, have a duty to be honest and open about every aspect of care they deliver. When mistakes are made, we want them acknowledged, patients informed and lessons to be learned.”

In 2009, the Healthcare Commission (now the Care Quality Commission) published a report into failings in emergency care provided by Mid Staffordshire NHS Foundation Trust. A further report into the care provided by the trust was published following an inquiry chaired by lawyer Robert Francis QC in 2010. Francis has also carried out a further review, which he intends to deliver to the secretary of state for health Jeremy Hunt by January 2013.

The contractual change is not a direct result of the recommendations, but is aimed at increasing transparency in the health service. “The importance of an open culture cannot be underestimated,” added Poulter. “We expect that Robert Francis will make further recommendations on the duty of candour when the Mid Staffordshire Inquiry is published and we are committed to taking whatever further action we think is needed as a result. But we cannot wait – creating this contractual duty of candour now ensures that NHS contracts for the next financial year will champion patients’ rights to basic honesty, as well as safe care.”

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