27/02/2019

The CQC’s recent confirmation that it had fined Bradford Teaching Hospitals NHS Foundation Trust £1250 for a failure to comply with the CQC’s Duty of Candour obligations for failing to apologise to a family within a reasonable period of time reflects the new tougher stance confirmed by Ian Trenholm in his first HSJ interview as CQC’s new chief executive, in which he confirmed that the sector should expect to see the number of prosecutions increase. The fine, a fixed penalty notice, is the first issued to a provider for a failure to comply with CQC’s Duty of Candour obligations and signals the CQC’s commitment to upholding the Duty of Candour regulation through the application of its 2014 enforcement powers.

The intention of the Duty of Candour is to ensure that providers are open and transparent with service users and those acting on their behalf in relation to care and treatment. It applies to all registered persons carrying on a CQC regulated activity.

As CQC Chief Inspector of Hospitals Professor Ted Baker made clear, the action taken does not relate to the care provided “but to the fact that the trust was slow to inform the family that there had been delays and missed opportunities in the treatment of their child. Patients or their families are entitled to the truth and to an apology as soon as practical after the incident – which didn’t happen in this case”.

It is therefore vital that providers are aware of their obligations and are confident that these obligations are successfully embedded within their policies, procedures and practices. A useful overview can be found in CQC’s guidance document ‘Regulation 20: Duty of candour, March 2015’, aimed at NHS bodies, adult social care, primary medical and dental care, and independent healthcare providers. CQC’s guidance makes it clear that the Duty of Candour applies to all ‘unintended or unexpected incidents’, as long as they result in the requisite level of harm, even if they are recognised complications of the treatment/ care; there does not necessarily have to have been a failing in the care provided.

Bevan Brittan regularly supports both NHS and independent health and social care providers on meeting their regulatory obligations to ensure safe patient care.  In addition to drafting policies and procedures, conducting audit reviews and addressing knowledge and skills gaps through training and workshops, we also work with a team of external regulatory specialists to undertake “mock” CQC inspections and staff interviews to assess the practical reality of your services, through independent eyes and to obtain useful feedback, before the inspectors (and the prosecutions) arrive.