• Provide all information directly relevant to the incident.


• Provide reasonable support to the service user.


• Inform the service user in writing of the original notification and the results of any further enquiries. In assessing whether harm is low,


moderate or severe, guidance can be obtained from the publication Seven Steps to Patient Safety, where the example given to illustrate the differences is a patient who suffers a perforation of the bowel during surgery. If recognised at the time, repaired, washed-out and antibiotics given, this would be classed as low harm. If the mishap was not picked up during the operation and resulted in septicaemia, with the patient requiring a return to theatre for repair, this would be moderate harm. Should the patient end up requiring a temporary colostomy and subsequent major operations this would constitute serious harm. Tere will invariably be issues over


categorisation of harm and one recent recommendation was to use the composite threshold of “significant harm” to cover moderate and serious harm and death. It is hoped that the final wording of the regulations can provide further clarity on this point.


Implications for hospital doctors Recent consultations on the statutory duty of candour have sparked debate about how it will operate, what it will cover and whether the draſt regulations will be applied


SUMMER 2014


consistently. But what is clear is that a statutory duty on service providers will be implemented. For the individual hospital doctor, the best


advice is to ensure that they follow existing GMC guidance in telling patients when things go wrong and a patient is harmed. A prompt and full explanation of the short and long-term effects of the mistake along with an apology will not be seen as an admission of liability. Te existing ethical duty on doctors is wider than the proposed statutory duty of candour, or indeed the contractual duty, so a doctor following this should be open and transparent with his patients in any case. However, as the statutory duty is likely to tie-in with the current contractual duty, it is also paramount that all hospital doctors understand and follow their organisations’ procedures for reporting patient safety incidents. Careful note-taking and documentation of any discussion explaining a mistake is also vital. Where there are uncertainties over


specific cases, advice should be obtained by contacting MDDUS.


n Majid Hassan is a partner in clinical law at Capsticks Solicitors LLP who advise MDDUS on legal claims


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