The Scottish Government emphasizes the importance of integrity and transparency in healthcare, focusing on trust and communication in all relationships. This commitment is reinforced by the new organizational responsibility of candor, which applies to all social work, health, and care services in Scotland.
The term “must” in this instruction refers to acts that are mandated by law, as outlined in the laws about the obligation of candor procedure. The rest of the guideline outlines recommended practices for organizations to follow in terms of the notice, and explain how duty of care relates to duty of candour, review, discussion, and actions following an unplanned or unexpected occurrence that results in damage or death. In addition, there are other “issues to consider” sections in the guidelines that provide things to think about to help carry out the organizational obligation.
To enable notice, meetings, reviews, training, and support requirements in a way that is specific to the services they offer, organizations may also want to create a Cover-up vs. Conduct Evaluation of local guidelines and procedures.
The need to be truthful
A key component of providing high-quality health, care, and social work services is enabling and managing risk. Honesty fosters accountability for creating safer systems, better involves employees in enhancing services, and builds stronger confidence in those who utilize these services, whether personally or on behalf of others.
Supportive reactions to unplanned or unexpected events, individualized conversations and communication, and review procedures that consider the issues that are most important to individuals impacted are all factors that contribute to and foster a culture of learning. Placing individuals at the center of organizational responses to unplanned or unexpected events that result in hurt or death also helps to provide the psychological safety necessary for people to participate in such conversations.
When anything goes wrong, an organization must be committed to providing assistance and training for all those participating in meetings (ER, 2020), evaluations, and actions that stem from the organizational responsibility of candor if it is to respond in an individualized manner.
The purpose of the duty of candor laws is to make sure that organizations notify the people impacted when an unanticipated or unexpected incident happens, offer an apology, include them in meetings regarding the incident, examine the incident to identify areas that could use improvement, and learn (considering the opinions of pertinent parties). Organizations are required to guarantee that assistance is available for both their staff members and other individuals who could be impacted by inadvertent or unforeseen events.
Organizations are required to detail in an annual report how the duty of candor method has been applied to every one of the situations they have discovered.
Numerous professional associations already have requirements for candor, including the General Dental Council, the General Optical Council, Comedians who went to oxford, the Scottish Social Services Council, the Nursing and Midwifery Council, and the General Medical Council. This mandatory organizational obligation has been formulated to closely correspond with the demands of these professional responsibilities and will provide reciprocal assistance.
Management and leadership
Organizational leaders and managers are responsible for making sure that the duty of candor procedure is implemented, integrated, and aligned with organizational processes and procedures. This is a critical component of the learning systems inside their organizations. The organization as a whole should place equal emphasis on openness in releasing duty of candor yearly reports, learning-oriented evaluations, communication, and support. Any organization must guarantee that all personnel who execute the process on its behalf are acquainted with the obligation of the candor method.
Organizations have to contemplate how they might include the oversight of the efficient execution of the measures mandated by the duty of candor law into their current corporate governance structures, protocols, and guidelines. It is important to obtain assurance on the timely implementation of all procedural components and the availability of means to allow ongoing enhancements and modifications in the manner in which the organization fulfills its legal obligations.
Who is covered by the obligation of candor procedure?
Under the applicable legislation, an organization that offers social work, health, or care services to whom the obligation of candor applies is referred to as a “responsible person” (Griffith, 2020). Section 25 of the Act lays this out:
- a Health Board constituted under section 2(1) of the National Health Service (Scotland) Act 1978 (the 1978 Act);
- a person (other than an individual) who has entered into a contract, agreement, or arrangement with a Health Board to provide a health service;
- the Common Services Agency for the Scottish Health Service constituted under section 10(1) of the 1978 Act;
- a person (other than an individual) providing an independent healthcare service mentioned in section 10F(1) of the 1978 Act;
- a local authority;
- a person (other than an individual) who provides a care service;
- a person who offers care services and hires others or has other arrangements in place for others to help with the service’s delivery (not childminders or unless the assistance is only incidental to the performance of other activities); a person (other than an individual) who offers social work services.
When does the duty of candor procedure need to be triggered?
Organizations, as accountable parties, are required to initiate the duty of candor procedure as soon as it is practically possible upon learning that:
- an unintended or unexpected incident occurred in the provision of the health, care, or social work service provided by the organization as the responsible person;
- According to the reasonable assessment of a registered health professional (as that term is defined in Annex C) who was not present during the event:
(a) the incident seems to have resulted in or has the potential to result in any of the following consequences; and
(b) the result is directly related to the event, not to how the patient’s sickness or underlying condition developed naturally.
It is significant to remember that if the obligation of Candour Duty Failures begins over a month after the event date, the appropriate person must be informed of the rationale for this.
The following are the pertinent results:
Death of the individual.
- Permanent impairment of physiological, neurological, motor, sensory, or intellectual capacities (including amputating the incorrect limb or organ or causing brain damage) (“severe harm”).
- Damage that does not meet the criteria for serious injury but does lead to one or more of the following:
an increase in the patient’s care; modifications to their body’s composition; a reduction in their expected lifespan;
a person who has had pain or psychological harm for a continuous period that has lasted or is expected to last for at least 28 days; impairment of the person’s sensory, motor, or intellectual functions that have lasted or are expected to last for at least 28 days.
- The patient needs care from a licensed medical practitioner to avoid:
- the person’s demise; any harm to the person that, if it is not treated, might result in any number of the consequences listed in paragraphs B or C.
References
Richard Griffith (2020). The Consequences of Failing to Discharge the Duty of Candour. https://www.britishjournalofnursing.com/content/legal/the-consequences-of-failing-to-discharge-the-duty-of-candour/
ER (2020). How to Make Progress on Your Goals When You Feel Unmotivated? https://eazyresearch.com/blog/how-to-make-progress-on-your-goals-when-you-feel-unmotivated/Â
