New guidelines have been issued telling medical staff including nurses, midwives and doctors to be more honest with their patients and apologise after making errors. These guidelines from NHS regulatory bodies come in aftermath of the Mid Staffordshire hospital scandal, and are part of an attempt to make the NHS more open.
The guidelines are a joint initiative between the General Medical Council (GMC) and the Nursing and Midwifery Council and are intended to put the onus on medical staff to provide “clear and honest” explanations when things go wrong.
The British Medical Association (BMA) sounded a note of caution by saying that staff should not be apologising for anything before it had been established who or what was actually at fault.
These new guidelines follow hot on the heels from other changes which mean that hospitals are now legally obliged to release information about patients who suffer moderate or significant harm and then have to apologise. Jeremy Hunt, the Health Secretary, said that the new guidelines on apologies are part of a wider issue to improve safety throughout the NHS.
The Chief Executive of the GMC, Niall Dickson, agreed that patients should be given a “clear and honest” explanation when mistakes were made. However he said one of the biggest challenge in the NHS currently was trying to be more honest and open about mistakes.
Dr Mark Porter, head of the BMA (British Medical Association) argued that doctors should never be put in the position of being asked to apologise when the reason for the mistake had not been properly established. He also said that most poor outcomes were down to systemic failures rather than being the fault of any individual.
The BMA position should not come as a surprise – consistently they seem to have taken the view the mistakes I never the fault of doctors negligence or errors – is always someone else to blame, usually “the system” or inadequate funding. Their arrogance in seeming to refuse to take on any responsibility whatsoever for the significant number of medical errors and medical negligence cases that plague NHS is staggering.
A report from the Patients Association warned that as many as half of all patients who make a complaint about care in the NHS have concerns about potential implications before they make that complaint. The survey looked at complaints made by 1,200 patients about their own care, or that of a close family member. 50% of those surveyed were concerned that making a complaint would affect the quality of care given.
Just about as many people felt that their complaint had been handled badly, and one in every three patients said that they did not believe that they were given an honest explanation about what had happened.
The Patients Association Chief Executive, Katherine Murphy, claimed that there were still “huge barriers” faced by patients lodging a complaint and said that the charity often had reports about hostile and inappropriate behaviour from members of medical staff. The report also highlighted that people who had lost a loved one in hospital had to suffer through an increased burden as the complaints procedure was just not fit for purpose.
This new NHS guidance comes after a call by Sir Robert Francis QC to improve transparency and openness in the health service after the scandal at the Mid Staffs NHS Trust. Hundreds more patients than had been expected died in Mid Staffordshire hospital due to serious failings in care.
Our take on all of this is that it seems that yet again the NHS is talking about being honest an open, but there seems to be very little progress. The GMC seem loathe to admit that a doctor could ever be negligent and make mistakes. Until we can break through this arrogance barrier, there is no prospect of reducing medical errors in general and medical negligence in particular.
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