Duty of candour – organisations

All registered health and social care professionals in the UK are under a professional duty to be candid with patients when things go wrong. This professional duty of candour applies when the following conditions are both met:

• Something has actually gone wrong with their treatment or care, and
• The person concerned has suffered physical harm, psychological harm or distress, or where there might be implications for their future care.

The General Optical Council (GOC) standards for optical businesses also state that registered practices need to ensure services “are transparent; that complaints are handled fairly; and that staff are able to be candid” [1].

This means you should support the professional duty of candour within your organisation. You can do this by being familiar with and supporting the professional duty of candour. Read FODO’s duty of candour at a glance for professionals, and if you are registered with the GOC then you should also:

• “Tell the patient or, where appropriate, the patient’s advocate, carer or family, that something has gone wrong
• Offer an apology
• Offer appropriate remedy or support to put matters right (if possible)
• Explain fully and promptly what has happened and the likely short-term and long-term effects; and
• Outline what you will do, where possible, to prevent reoccurrence and improve future patient care” [1].

England

If you provide eye care under the NHS Standard Contract, then you should be aware of and comply with the contractual duty of candour. The contractual duty is set out in Service Condition (SC) 35.

SC35.1 applies to all providers and it states: “The Provider must act in an open and transparent way with Relevant Persons in relation to Services provided to Service Users.”

Unlike the professional duty of candour this contractual duty only applies “to incidents or suspected incidents that result in moderate or severe harm or death” [2]. Therefore, if you already support the professional duty of candour, the contract duty is unlikely to have any additional operational impacts.

If you are registered with the CQC then SC35.2-SC35.4 apply, which essentially mean you have to comply with your statutory duty of candour. Read more about the statutory duty below.

England

The statutory duty of candour applies if you are registered with the Care Quality Commission (CQC).

Primary ophthalmic services (for example, high street optometrists) or ophthalmic services that are of the same kind as those provided by high street optometrists are exempt from CQC registration [3], so the statutory duty will not apply in most cases in primary eye care settings.

If you perform a regulated activity and are CQC registered, then you will need to comply with Regulation 20: Duty of Candour and all clauses within Service Condition 35 of the NHS Standard Contract.

Scotland

Scotland introduced a statutory duty of candour for all organisations that provide NHS care in 2018 [4]. In March 2018 the Scottish Government published guidance on the organisational duty of candour [5] which applies to all NHS care commissioned by Health Boards, including GOS Scotland. Learn more.