A defensive NHS culture that implicitly prohibits medical professionals from saying sorry seems fairly ironic. Treating the symptoms of negligence rather than the cause? That’s not exactly cutting-edge medical practice.
The guidelines released this month by the General Medical Council, with what appears to be the backing of Health Secretary Jeremy Hunt.
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The guidelines state:
“You must be open and honest with patients if things go wrong. If a patient under your care has suffered harm or distress you must put matters right, if that is possible; offer an apology; explain fully and promptly what has happened and the likely short-term and long-term effects.”
These seem to be intelligent measures designed to stop doctors from suppressing evidence of wrongdoing and potentially making matters even worse.
Much of the modern NHS runs on information, with vast databases containing all relevant patient details. However, diagnoses are still dependent on the patient being honest and knowing the full facts behind their own medical history.
For this reason, the new guidelines are an extremely good idea for the doctors as well as the patients. Any attempt at covering up mistakes could affect future treatment as much as it affects the patient, compounding errors and resulting in potentially enormous repercussions over the long term. It’s not just altruism; it’s a sensible self-interested guideline as well.
Hiding or disguising information like this from the patient is always difficult in any case, and may end up backfiring spectacularly if the doctor ends up in court. It’s hard to come up with more damning evidence than an attempt to hide or disguise existing incriminating evidence.
As the guidelines state, “Poor communication may make it more likely that the patient will pursue a complaint or claim.”
One Patient, One Doctor
In other, related news, the Academy of Medical Royal Colleges said that henceforth every patient will have a named doctor and nurse who are responsible for all their care.
This move came partly in response to the disaster at Mid Staffordshire NHS Foundation Trust, where as many as 1,200 patients are thought to have died due to poor healthcare.
Implementing a system where there is clear accountability and liability may prove to be an important step in the right direction.
On the other hand, similar systems are already in place in most hospitals. It might be the case that only dysfunctional hospitals were avoiding issues of accountability in the first place.
Consistent, Competent Care
The idea joining these two new guidelines is that doctors should be more accountable. It should be immediately obvious who your healthcare professionals are, what they have done (or not done) to care for you, and what their plans are for your future care.
This seems to be a great ideal, and we hope that the initiatives are as successful in practice as they would seem to be in theory.
Other Calls For Doctors To Apologise
The calls from Jeremy Hunt for doctors to apologise to patients they have mistreated date back to at least January 2014.
Meanwhile, debate within the community dates back almost as long as medical malpractice law has existed.
A similar bill was proposed as early as 12th April 2012.
What Do You Think?
Do these guidelines change much? Do they overturn old myths and ideas about apologising and liability, or are they pretty much a continuation of the old methods of dealing with conflict?
Let us know in the comments!