NHS doctors and nurses must apologise for failings in care, says Jeremy Hunt

13 January 2014

NHS doctors and nurses must apologise for failings in care, says Jeremy Hunt

A ‘culture of defensiveness’ must cease and doctors and nurses must ‘say sorry’ when things go wrong in the NHS, says Jeremy Hunt, the Health Secretary.

The health secretary has suggested that winning back trust in the NHS can be achieved in the first instance by doctors and nurses being far more honest and open when things go wrong, ensuring that they “say sorry” and so reversing the mistrust patients associate with the NHS-something fostered over years of Labour role according to Hunt.

New guidance has been forwarded to every hospital in England and Wales making recommendations about apologising about failures that arise in patient care; this is a means to address the fact that staff are often fearful to apologise because they think they will make a situation worse or are admitting legal liability. The recommendations make clear that "saying sorry is the right thing to do" in all circumstances when there are failures of patient care.

Speaking to The Telegraph newspaper, Jeremy Hunt, the Health Secretary said the time for a defensiveness culture and attitude within the NHS must become a thing of the past.

He said: "We want to see an open NHS culture that focuses on safety and learns when things go wrong.

"Saying sorry and supporting patients and their families when they have experienced harm is a really important part of this. It’s great to see staff being supported to do the right thing.

"Sadly, under the last Government a closed and defensive culture developed in parts of the NHS. We are transforming this culture through a new transparency drive in our hospitals."

Such concerns over the culture and defensiveness of the NHS were heightened and scrutinised after a number of high profile care scandals within the NHS, where it was discovered that thousands of patients had to deal with disgraceful treatment and lack of care. Such instances led to suffering, exacerbation of previous illnesses and conditions and even death.

It was the scandal at the Mid Staffordshire NHS Foundation Trust that thrust the issue into the spotlight, highlighting the urgent need for change and a culture shift. There 1,200 patients died unnecessarily with a great more "failed by a system which ignored the warning signs and put corporate self-interest and cost control ahead of patients and their safety" according to The Francis Report.

The result of the findings ensured a further 11 trusts were placed under official investigation. These scandals highlighted the public realisation that treatment and care within the NHS had seriously deteriorated in some areas. As a result a four-age leaflet-entitled “saying sorry”-has been produced by staff with recommendations.

Some of the recommendations described in the leaflet include

-Staff should make face-to-face apologies to patients as soon as they are aware an incident has happened

-A written apology should follow this, clearly stating the healthcare organisation in question is genuinely sorry for any suffering and distress arising from the incident in question

The NHS Litigation Authority-which produced and sent out the leaflet-has made clear that "Saying sorry is not an admission of legal liability" but is "the right thing to do."

Catherine Dixon, chief executive of the NHS Litigation Authority, said: "Saying sorry is the human and moral thing to do.”

"We actively support organisations being open, transparent and candid with their patients. We have seen some cases where that hasn't happened in the NHS. It's important that we create and support the right culture. It can win back people's trust."

Mrs Dixon said that the NHS is this year facing a 20 per cent rise in claims against medical staff to around 12,000.

The Francis inquiry into care failings at Stafford hospital resulted in the introduction of a “statutory duty of candour” which means that families must be informed if errors in treatment cause death or serious injury.

The Francis inquiry highlighted the poor care at Mid Staffordshire Foundation trust, where more than £1.2 million has been paid out to 120 victims of poor care there in the largest ever group claim against the NHS.

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