Medical staff working at all levels in the NHS have been told to start being open and honest with patients when things go wrong, in ground-breaking new guidance. Regulators have issued new guidelines in the aftermath of the Mid Staffs scandal in an attempt to make fundamental changes to NHS culture.
The General Medical Council (GMC) and the Nursing and Midwifery Council [ the NMC]have come together to issue the proposals, which urge nurses and doctors to be honest and open with their patients when there are unacceptably poor levels of care, or medical errors are made.poor .
The BMA however was quick to seek reassurance that staff will not be asked to make apologies before the incident had been investigated and fault had been established.
These new guidelines come after a new law last month which stated that NHS Trusts are now obliged to give information about all incidents which cause patients significant or moderate harm, and then apologise. The Health Secretary, Jeremy Hunt, has stated that these new guidelines are just part of the drive to make the NHS safer.
The Chief Executive of the General Medical Council, Niall Dickson, said that patients had the right to an honest explanation when something goes wrong with their care, but said that changing the NHS to make it more open and honest was a huge challenge. The Chair of the BMA, Dr Mark Porter, raised concerns that doctors should never be forced to apologise in situations where the fault had not been established and said that the majority of poor outcomes were down to system failures rather than the fault of any particular individual.
Are patients simply scared of making a complaint?
A recent report by the Patients Association reveals that half of patients who do complain about the NHS feel that there may be repercussions when making a complaint. 1,200 patients who had formally complained about their own care or the care of a family member were surveyed and half worried that care would be adversely affected by complaining. A slightly lower number said that they felt their complaint had been handled badly, and didn’t believe staff had been completely honest in their explanations.
Patients Association head Katherine Murphy, said that there continued to be “huge barriers” for patients who wanted to complain, and that patients frequently told the charity that they often faced behaviour which could be considered inappropriate.
The report also commented on the particular burden suffered by people who had been bereaved, as the complaints process failed them so often.
Is this a sign of a change in the culture of the NHS?
Sir Robert Francis QC called for a change to NHS culture after the Mid Staffs scandal, and this new guidance is seen as one of the ways in which the NHS is becoming more transparent. The aim is to stop the excess patient deaths and failings in care suffered in Mid Staffs from happening again.
So what do we think about all of this? Well it’s amazing that this issue keeps rearing its head and nothing substantial seems to happen. The GMC don’t want to admit that there are situations in which a doctor ever makes mistakes. We need to get past this arrogant point of view if we are to tackle medical negligence, and until we do, medical mistakes will remain far too common.
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