Being candid

01 In 2014, the General Optical Council (GOC) signed up to a joint statement with other healthcare regulators which outlined our expectations of professional duty of candour from our registrants.

The signed statement was borne out of the Robert Francis Review into poor care and high mortality rates at Mid Staffordshire NHS Foundation Trust, in which there was a recommendation to formalise the professional duty of candour more thoroughly for healthcare professionals.

Of course, prior to this formalisation, there would have always been an expectation that healthcare professionals would be open and transparent with their patients.

02 We subsequently carried out a review of our own professional standards for optometrists and dispensing opticians. In 2016, we introduced Standard 19, which outlines what professional duty of candour is and what we expect from our registrants.

At the heart of the duty of candour is the principal that registrants should be open and transparent with patients when things have gone wrong. That is a duty that applies to all healthcare professionals, not just optometrists and dispensing opticians.  

We encourage registrants to famililarise themselves with the concept of duty of candour and what it means for them in practice. Our main message is that registrants should not be scared to be candid, it’s something that is beneficial to both them as a practitioner and to patient care – ultimately, it helps to resolve concerns at a local level. 

At the heart of the duty of candour is the principal that registrants should be open and transparent with patients when things have gone wrong

03 After formalising the duty of candour in our standards, it became clear that registrants were unsure of what it meant for them fully in practice.

We responded to this by producing further supplementary guidance on duty of candour, which we published in 2017. 

In that supplementary guidance we talk about the different elements of the duty of candour, as well as the learnings that practitioners may take from these situations and where they might seek further support and advice. We encourage registrants to consult with their colleagues, peers, employer and professional associations if they are unsure of how to act in these circumstances. 

04 A common question that we have been asked about duty of candour is how it applies to the registrant in practice.

Essentially, what it means is that where the practitioner has identified that something has gone wrong in practice with patient care, they are open and transparent about it. They should explain what has happened to the patient or their carer, and take the necessary steps to rectify what has happened and ensure the future health of that patient. As part of that, an apology to say sorry for what has happened must be offered. 
 

Registrants are also sometimes not clear about difference between a complaint and duty of candour; there has been confusion about this terminology in the past. A complaint is not necessarily a situation that may require you to be candid. A complaint is where a patient may outline a circumstance that they think has happened, but at that point you do not know if it has actually happened or caused harm to the patient. The duty of candour only applies when you are aware that something has gone wrong with a person’s care. 

We would still expect registrants to deal with complaints in an appropriate manner.

05 There’s nothing wrong with apologising, it is not an admission of liability.

The GOC is very strongly of the view that an apology is not an admission of liability, and it is the right thing to do in that particular circumstance. A lot of patients will be reassured by the fact a practitioner is apologising for what has happened, particularly if they are also explaining what they will do to rectify it. That, in turn, may prevent the further escalation of a situation which could result in a more serious complaint to the GOC or other parties.

There is always the need for registrants to take account of the situation and apply their own professional judgement to each particular scenario. Sometimes they may be offering an apology on behalf of an organsiation or another colleague, but it always requires them to apply their professional judgement and act appropriately. 

The GOC is very strongly of the view that an apology is not an admission of liability, and it is the right thing to do in that particular circumstance

06 Today we receive very few questions or queries relating to duty of candour and its requirements.

It will be interesting to see if questions on duty of candour and how it applies to businesses and the support staff that work for within a business arise when we publish our new business standards, which we are currently consulting on. 

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