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Duty of Candour


26-March-2018

We all share a common purpose as partners in health and social care – and that is to provide high quality care and ensure the best possible outcomes for people using care services. Promoting improvement is at the heart of what we do. We know that we deliver exceptional care on a daily basis but sometimes things go wrong and it’s how we deal with these incidents that is important. The Duty of Candour provisions in legislation set out a range of things that need to happen when unexpected or unintended harm has occurred. 

Health (Tobacco, Nicotine etc. and Care) (Scotland) Act 2016

The Health (Tobacco, Nicotine etc and Care) (Scotland) Bill, which included at Part 2 the Duty of Candour provisions, was given Royal Assent on 6 April 2016.  The implementation date for the Duty of Candour provisions is 1 April 2018.  Regulations in respect of the Duty of Candour provision were laid before the Parliament on 12 February 2018.  These are available here

The purpose of the duty of candour procedure is to support the implementation of consistent responses across health and social care providers when there has been an incident that has resulted in unintended or unexpected harm which is not related to the course of the condition for which the person is receiving care. 

The duty of candour procedure outlines how responsible organisations must respond to people when unintended or unexpected harm has been caused.  The procedure applies to all organisations providing health and social care services in Scotland.  

Organisations are required to follow the duty of candour procedure which includes notifying the person affected, apologising and offering a meeting to give an account of what happened. The duty will also require the organisation to review each incident and consider the support available to those affected (both those who deliver and receive care and support services). Organisations have a requirement to publish an annual report on when the duty has been applied. This will include the number of incidents, how the organisation has implemented the duty and what learning and improvements have been put in place. 

NHS Education for Scotland (NES), Healthcare Improvement Scotland (HIS), the Care Inspectorate (CI) and Scottish Social Services Council (SSSC) have been working in partnership to develop a range of education and training resources that will support implementation of the new procedure across Health and Social Care. 

Education and training for Staff 

The education and training has sought to address how existing processes within organisations (for example adverse event reviews, significant case reviews, processes for regulated services to notify regulators etc) could be aligned with the Duty of Candour outcomes outlined at section 21(4) of the Act. This recognises the various electronic recording systems used and considers changes that may need to be made to these systems to ensure that appropriate monitoring and recording of duty of candour procedure incidents can be made.

We have developed, designed and disseminated a range of printed materials for health and social care organisations that have also been made available electronically.  This has included a leaflet outlining the elements of the Duty (leaflet).

This has been supplemented by a series of factsheets with more detail about responsibilities of staff and organisations as well as including sources of support.  These factsheets include:

Duty of Candour Procedure (Procedure)

Duty of Candour – Apology (Apology)

Duty of Candour – Monitoring and Reporting (Reporting

NES has disseminated these resources directly to all Health Boards and indirectly, through our partners CI and SSSC, to social care organisations.  NES continues to distribute these printed resources on request.  

We have also designed and developed an e-learning module for use on various learning management systems across health and social care services. The module is already available on all NHS Board learning management systems and the appropriate files have been shared with SSSC and CI to make them available to social care staff.  The module is also available through our ‘Little Things Make a Big Difference’ website (module) and also on Turas Learn (https://learn.nes.nhs.scot/).  Staff will need to register for Turas Learn and then search for Duty of Candour.  This enables access for anyone who does not have it through a learning management system (including some independent practitioners, their staff in health and any independent providers in social care).  The module is available for PC at present and will shortly also be available for iPad/tablet.  

The module provides basic information regarding the new Duty as well as scenarios to understand how to implement skills in practice, such as having a difficult conversation or making an apology. 

Scottish Government have established a dedicated page including FAQs on their website (http://www.gov.scot/Topics/Health/Policy/Duty-of-Candour) and also a dedicated email address for any questions (dutyofcandour@gov.scot). 

For further information please contact:

Jane Davies – NHS Education for Scotland - jane.davies@nes.scot.nhs.uk

Nanisa Feilden – Healthcare Improvement Scotland – Nanisa.feilden@nhs.net

Laura Lamb – Scottish Social Services Council – laura.lamb@sssc.uk.com

Maureen Gunn – Care Inspectorate – Maureen.gunn@careinspectorate.com

 

Jane Davies
NMAHP
March 2018