1. Introduction
Coast Medic Ambulance is committed to providing high-quality and safe services to all patients. In alignment with the Care Quality Commission (CQC) regulations and NHS guidance, this Duty of Candour policy outlines our responsibilities and procedures for ensuring transparency and honesty when things go wrong with the care and treatment we provide.
2. Policy Statement
The Duty of Candour is a legal and ethical requirement for health and care providers. Coast Medic Ambulance pledges to uphold this duty by being open and honest with patients, their families, and carers when an incident results in harm. This policy ensures compliance with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20 and supports the principles of the NHS Constitution.
3. Scope
This policy applies to all employees, contractors, volunteers, and anyone working on behalf of Coast Medic Ambulance. It covers all services provided by the organization, including emergency and non-emergency patient transport.
4. Definitions
- Duty of Candour: A legal duty to be open and honest with patients and their families when something goes wrong that causes or has the potential to cause significant harm in the provision of care.
- Notifiable Safety Incident: Any unintended or unexpected incident that occurred during the provision of a regulated activity that, in the reasonable opinion of a health care professional, appears to have resulted in significant harm, moderate harm, prolonged psychological harm, or death.
5. Regulatory Framework
- Care Quality Commission (CQC): Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20.
- NHS Guidance: NHS Standard Contract, Service Conditions (Duty of Candour).
6. Responsibilities
- Management: Ensure the implementation and compliance with this policy. Provide training and resources to staff.
- Staff: Adhere to the principles and procedures outlined in this policy. Report incidents promptly and participate in investigations.
- Patients and Families: Engage in open communication with the organization regarding their care and treatment.
7. Procedure for Duty of Candour
Identification of a Notifiable Safety Incident
- Immediately identify and assess any incident that may qualify as a notifiable safety incident.
- Document the incident in the incident reporting system.
Notification to the Patient and/or Family
Initial Notification:
- Inform the patient and/or their family as soon as reasonably practicable, and within 10 working days of the incident being identified.
- Provide a factual account of what happened, including known facts, without speculation.
- Offer a sincere apology for the incident and its impact.
Written Notification:
- Follow up the verbal notification with a written summary of the discussion, the facts as known, and the apology provided.
- Ensure the written notification is clear and compassionate.
Investigation and Follow-up
- Conduct a thorough investigation to determine the root cause of the incident.
- Keep the patient and/or their family informed of the progress and outcomes of the investigation.
- Provide additional support or information as needed.
Documentation and Record-Keeping
- Maintain detailed records of all communications with the patient and/or their family regarding the incident.
- Document the investigation process, findings, and any corrective actions taken.
8. Training and Awareness
- All staff members will receive training on the principles and application of the Duty of Candour.
- Regular refresher training sessions will be conducted to ensure ongoing compliance and awareness.
Monitoring and Compliance
- Regular audits will be conducted to ensure adherence to the Duty of Candour policy.
- Feedback from patients and families will be collected and reviewed to identify areas for improvement.
- Non-compliance with this policy will be addressed through performance management processes.
Support for Staff
- Provide support to staff involved in notifiable safety incidents, including access to counseling services and debriefing sessions.
- Foster a culture of openness and learning, encouraging staff to report incidents without fear of retribution.
9. Review of Policy
This policy will be reviewed annually or more frequently if required due to changes in regulations, guidance, or organizational needs.
10. References
Care Quality Commission (CQC) – Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 20.
NHS Standard Contract, Service Conditions (Duty of Candour).
11. Appendix 1: Timelines
| Requirement under Duty of Candour | Timeframe |
| Patient or their family/carer informed that incident has occurred (moderate harm, severe harm or death) | Maximum 10 working days from incident being reported |
| A verbal notification of incident (preferably face-to-face where possible) unless patient or their family/carer decline notification or cannot be contacted in person. A Sincere expression of apology must be provided verbally as part of this notification. | Maximum 10 working days from incident being reported |
| Offer of written notification made. This must include a written sincere apology. | Maximum 10 working days from incident being reportedA record of this offer and apology must be made (regardless if it has been accepted or not) |
| Step-by-step explanation of the facts (in plain English) must be offered. | As soon as practicable This can be an initial view, pending investigation, and stated as such to the receiver of the explanation. |
| Maintain full written documentation of any meetings. | No timeframe If meetings are offered but declined this must be recorded. |
| Any new information that has arisen (whether during or after investigation) must be offered. | As soon as practicable |
| Share any incident investigation report (including action plans) in the approved format (Plain English) | Within 10 working days of report being signed off as complete and closed |
| Copies of any information shared with the patient to the commissioner, upon request. | As necessary |
12. Appendix 2: Written Notification
Template for Patient Notification
Dear <<PATIENT NAME>>,
We believe that you have been involved in an adverse event that has occurred with Coast Medic’s service provision;
<<DESCRIPTION OF INCIDENT>>
I wish to express my sincere apology that this event has occurred. Coast Medic aims to provide a quality service to everyone and to investigate promptly such adverse events and share findings with those involved.
We would like to invite you, if you wish, to attend a meeting to provide a step-by-step explanation of the events and circumstances. In relation to this meeting, I would appreciate your preferences on the following;
Your preferred time and date of meeting
Where would you wish to meet/proposed venue if there is any reason that this cannot be at the Practice premises.
Please feel free to bring a friend or relative to offer you support during this meeting. Following this we will provide further information relating to the outcome of the investigation.
If you would prefer not to attend a/any meeting(s), or to not receive information regarding the outcome of the investigation, please let us know. Otherwise, on completion of our investigation, we will write to you to provide feedback regarding the outcome of this investigation.
<<Staff Name>> will be acting as your lead contact for the duration of this process and they can be contacted on 01872 755120 Extension <<EXT>> or <<emailname>>@coastmedic.org.uk
Yours sincerely,
Luke Tudor
Chief Executive.