All nurses, midwives and doctors have a professional duty to raise concerns about possible failings in the provision of care, as part of new guidance released by the NMC and the GMC.
The guidance, Openness and honesty when things go wrong: the professional duty of candour, states that 'healthcare professionals must also be open and honest with their colleagues, employers and relevant organisations' when failings are identified, as well as cooperating in any investigations led by their relevant regulatory body.
The guidance is aimed at creating a 'learning culture' to ensure that when there are errors in patient care, they are addressed as early as possible, and prevented in the future. It states that all healthcare organisations should have a policy for reporting adverse incidents and near misses in place, which must be followed by all staff.
For practice and community nurses, who often work in isolation, Dr Katerina Kolyva, director of continuing practice at the NMC, said that managers and GPs had an 'extra responsibility to promote the duty of candour' and that practice nurses with concerns could also turn to the CQC if they felt that they could not raise concerns..
Jackie Smith, chief executive of the NMC, said: 'We believe that the public's health is best protected when the healthcare professionals who look after them work in an environment that openly supports them to speak to patients or those who care for them, when things have gone wrong.'
Dr Kolyva added: 'All members of the NMC and GMC are bound by the duty of candour. The CQC can provide an extra layer of assurance. I would think that they will examine the practice's adherence to the duty of candour, and would be able to find any failings during meetings with staff and patients.'
The guidance also stresses the importance of maintaining good relations with patients in the event of something going wrong. It emphasises the need for nurses and other staff to apologise and be honest with patients about issues surrounding their care.
Nurses should explain to the patient what went wrong, what will be done to address the situation, and what measures will be taken to ensure that another patient is not harmed in a similar incident. It also highlights the fact that nurses are not admitting legal liability for an incident of poor care by apologising to a patient.
Ms Smith added: 'We can't stop mistakes from happening entirely and we recognise that sometimes things go wrong. The test is how individuals and organisations respond to those instances, and the culture they build as a result.'