The announcement in the press of new duty of candour rules on Monday left me feeling confused and perplexed.
As a registered nurse I’ve always held the view that being open and honest with the people I serve is part and parcel of being the very thing I trained to be. Surely being open and honest includes admitting when things have gone wrong? Offering a sincere apology for mistakes or shortcomings should not be seen as exceptional? We have all experienced situations in life where we’ve been let down by others and/or systems. We initially feel very angry; yet if we think about those situations, a heartfelt apology from the other side can diffuse the situation so readily.
If, therefore, saying sorry isn’t rocket science, why have we found ourselves in the situation we are in? There are a number of reasons:
Fear of being sued
We are all aware of the increasingly litigious society in which we live. Remember the TV slogan, “Where there’s blame, there’s a claim”? So many of us are afraid to be open and honest and to offer an apology is a synonym of admitting criminal liability. That perceived fear then is allowed to grow and fester inside organisations, from top to bottom, when we notice something wrong we don’t want to admit to anything as we are worried the next day our photo will be in the papers and the day after we’ll be in the dock.
Fear of regulators
Now I’m not for a moment condoning bad practice and health professionals who do fall short of the mark must be held to account. However, we need to dispel the myth that any and every mistake that’s made means an automatic hearing in front of the professional standards committee. When something goes wrong we need to look on this as an opportunity to learn – can systems and processes be improved? Everyone needs to support those involved in errors. That may mean remedial actions for the individuals, but that should not be viewed as a stain forever on their character (or records). Instead, it is a strength to acknowledge something isn’t as it should be.
Not focusing on the fundamentals
Lots of the issues raised about our healthcare are often around the fundamentals of care. Not being spoken to correctly (or at all), personal care not being provided, and so on. These are surely things all human beings should be aware of? I applaud Kate Granger’s #HelloMyNameIs campaign that took social media by storm.
When we’re not feeling very well, say with a common cold, nothing makes us feel better more than a nice warm bath, a change of bedding, or cleaning our teeth. Yet why do these things get overlooked time and time again for patients in our health system?
Often we hear the cry “we’re too busy!’’ and I agree, hospital wards and departments are very busy; but we need to ensure that we get the basics right for our patients. We know that so much can be learned about our patients from giving them individual personal care. A good nutritious meal aids wound healing, for example. Giving fundamental care improves the experience of healthcare for the patient but it’s in our own interests too. Good fundamental care improves outcomes.
Fundamentals of care should be seen as a high priority and all of us have a part to play. I was so encouraged on a recent trip to the wards when a hospital consultant assisted a patient who needed help walking to the toilet, rather than getting someone else to do it.
By getting the fundamentals right we are going to make our patients happier and healthier, it’s what we all want.
Viewing the new duty of candour guidelines in a vacuum will achieve little, we need to look at the essence of why we are here. We need a much more meaningful discussion on how we should all respond.
Please note that the views expressed in this blog do not necessarily represent the views of Skills for Health.
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