01 April 2016

Focus on Standard eight: Be open when things go wrong

Michael Guthrie, HCPC’s Director of Policy and Standards talks about a new standard which requires registrants to be open and honest when things go wrong.

What does the new standard say?

Standard eight says that registrants need to be open and honest when something has gone wrong with the care, treatment or other services that they provide. This includes letting service users and carers know; apologising; and taking action to put matters right if they can. The standard also says that registrants need to support service users and carers to raise concerns and be helpful and honest in their responses to complaints.

Why a new standard and why is it important?

The reports of inquiries into failings in health and social care services in recent years have emphasised the importance of organisations and individuals being open and honest when service users are harmed or could have been harmed, as a result of errors or mistakes in the care or treatment they have received. This is sometimes referred to as a ‘duty of candour’. In England, there is now a statutory duty of candour which some organisations in health and social care have to meet, and similar requirements are being introduced in the other UK countries.

The previous version of the Standards already required registrants to be honest and to protect service users from harm. The new standard builds on this to set out clearer and more specific expectations. We do not use the term ‘candour’ because of feedback that this term was not always understood.

The other UK wide regulators of health and care professionals either have or are introducing a similar standard for their registrants. We all want to make a small, but important, contribution to creating a culture that supports professionals being open and honest with service users and carers about mistakes and errors and one which is open to, and acts on, feedback – both positive and negative.

What does this mean for registrants?

We are asking registrants to be transparent in their work and to act appropriately to make sure that service users and carers are not kept in the dark when something goes wrong.

The work that health and care professionals do is very often highly pressured and rarely risk free. The standard isn’t about penalising registrants when inevitably mistakes happen or where outcomes are not as beneficial as they had hoped. But it is about expecting registrants to act appropriately when they identify that something has gone wrong. This includes letting the service user know but also, for example, making sure that any records are completed accurately. For registrants who are employed, this includes making sure that they use their employer’s incident reporting arrangements where appropriate.

The Standard includes an expectation that registrants will apologise when something goes wrong. Service users and carers have fed back to us about the power of apologies – that though simple and easy to give, they make a huge difference to the service user, and to their relationship with the professional, even where the person apologising had not made the mistake. We know that sometimes professionals can be reluctant to apologise for fear of the consequences. We are very clear that an apology is a positive thing and not an admission of liability or wrongdoing.

As with any of our standards, we expect registrants to use their professional judgement. For example, some registrants will work in teams where it might be more appropriate for another professional to inform a service user or to make an apology. We expect registrants to adhere to the principles of these standards and that they are able to justify their decisions and actions if asked to.

Further information about the Standards of conduct, performance and ethics is available here.

For more information about Standard eight, or to address any queries you may have, join in our tweetchat on Thursday 21 April at 6.00pm using the hashtag #my_standards

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