Hospitals will be forced to admit medical errors, says government

New duty of candour to be written into third-party NHS provider contracts following government’s ‘listening exercise’ The Department of Health has published its full response to last week’s NHS Future Forum report , accepting many of the forum’s recommendations and introducing a drive for transparency that will require hospitals to admit errors. A written ministerial statement said hospitals would have a new “duty of candour”, requiring them to tell patients when they had made mistakes – a key demand from the “listening exercise”. Providers of NHS services would have the duty written into their contracts in a drive to increase transparency. The government has moved to eliminate the chances for “cherry-picking”, whereby private providers seek to take on the most profitable operations. Royal colleges – professional bodies for health professionals – would be enlisted to develop safeguards to eliminate this. The document added to the modifications the government had already said it would make to the controversial health and social care bill, including watering down requirements on competition . Having resolved major differences between the coalition partners, the government hopes the bill will clear the House of Commons before the summer recess, and go to the Lords early in the autumn. High profile Liberal Democrats, such as former MP Dr Evan Harris, have voiced continuing concerns about the new direction of the bill. They have three concerns that could threaten a new rebellion like the one that saw the Lib Dem leader, Nick Clegg, forced to insist on a pause in the bill’s progress. Harris has highlighted the danger of essential NHS services being undermined by large numbers of more straightforward cases – and the income that goes with them – being farmed out to private or third sector providers, leaving more expensive A&E or intensive care units unviable. “The NHS doesn’t need any favours on a level playing field, but in the end it has to provide these emergency and rescue services and it can’t do that in a free market,” Harris said. A second concern is the potential for clinical commissioning groups to outsource work to private companies with vested interests, beyond the scope of full public scrutiny. Harris is also concerned that the government is still only placing a responsibility on the secretary of state to have a “duty to promote” rather than the stronger duty to “provide or secure the provision of” a comprehensive NHS service. The health secretary, Andrew Lansley, said the response to the report built on changes already agreed to the health bill. The government has said doctors and nurses will be involved in planning and buying care, while a 2013 deadline for commissioning consortiums to take on budgets has been scrapped and the NHS regulator, Monitor, now has a duty to promote the interest of patients when it comes to competition. Explaining the “duty of candour” principle, the response statement says: “We heard through the listening exercise the suggestion that we could strengthen transparency of organisations and increase patient confidence by introducing a ‘duty of candour’: a new contractual requirement on providers to be open and transparent in admitting mistakes. “We agree. This will be enacted through contractual mechanisms and therefore does not require amendments to the bill. We will set out more details about this shortly.” The “candour” pledge comes as new research suggested basic failures in co-ordinating care led to errors in medication and other forms of treatment. The study, published in the International Journal of Clinical Practice, included 1,434 British patients. Some 9% reported medication or medical errors, with 23% saying poorly co-ordinated care was involved – increasing the likelihood of error by 160%. Lansley said: “We want to deliver continuous improvements in the quality of NHS care. Too often, data about what goes wrong in the NHS is not used to drive improvements. That’s why we are introducing a requirement on providers to be open and transparent in admitting mistakes. “In addition, we are asking foundation trusts to hold their board meetings in public. This will help to foster a culture of openness in the NHS and improve patient confidence. A transparent NHS is a safer NHS.” Have your say on our NHS reforms coverage Health policy NHS Health Andrew Lansley Public services policy Allegra Stratton guardian.co.uk

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