Doctors still fear admitting errors

By a staff reporter

Doctors are overwhelmingly aware of and comply with their duty to be open and honest with patients when something goes wrong – but nearly a third fear the consequences of admitting errors.

An MDU survey of 418 doctors found:

 98% were familiar with the statutory duty of candour, which requires organisations to be open and honest with patients if they experience at least moderate harm after an incident; 

 99% also reported responding to an incident in line with their legal and professional duties by apologising to patients, providing an explanation and putting things right if possible;  

 71% of doctors had no concerns about always being open and honest after an incident;

 29% said they sometimes felt unable to do so because they were worried about the patient’s reaction, being blamed or that they could face a claim for negligence; 

 The most common incidents involving the legal duty of candour were medication errors (45%), surgical problems (30%) and delayed diagnosis or referral (28%). 

The union urged legislators and policymakers to ensure no obstacles were put in the way of the open exchange of information after something goes wrong.

Dr Michael Devlin

Dr Michael Devlin, the defence body’s head of professional standards and liaison, said apologising meaningfully and explaining fully and promptly what had happened was vital for everyone involved in an incident, and was not an admission of legal liability.

But much work was needed to ensure an open and learning culture became the new norm. 

The legal duty of candour has been in place in England for six years and in Scotland for three. A similar duty will come into force in Wales in 2022. 

Northern Ireland’s government is consulting on proposals to introduce a duty of candour under which individuals and organisations breaching the duty could be guilty of a criminal office. 

Dr Devlin said this could be counterproductive, explaining: ‘If the proposals are fully adopted, Northern Ireland will be unique as the only UK country where the statutory duty applies to individuals as well as organisations, and where breach of the duty could attract criminal sanctions for clinicians.

‘History has taught us that criminalising medical errors of judgement does not make patient care safer. We believe it would have a chilling effect on the profession and be counterproductive to achieving the open and honest culture needed to put patient safety at the front and centre of everything we do.’

• See ‘Open and honest’