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Can professional regulation do more to encourage professionals to be candid when healthcare or social work goes wrong?

Advice to the Secretary of State for Health

This report is a response to your commission to provide advice specifically on the professional duty of candour rather than a statutory or contractual duty. In considering how professional regulation is functioning in this regard and whether any improvements should be made, we have reviewed research evidence, mapped regulators’ existing provisions, examined current activity and consulted with stakeholders in reaching our conclusions. We are very grateful for the input, interest and support from all those who have contributed to this work.

Regulators’ standards inform and influence not only professionals’ practice, but education and training providers, students, leaders and supervisors. As our paper describes in more detail, it is our view that the most effective approach would be for regulators, as a group, to improve the consistency and clarity of their standards around candour.

Improved consistency and clarity in standards could include all regulators developing a common standard, shared across the regulated professions (or at least common principles upon which specific standards can be based). As a minimum, it is our recommendation that regulators should unite to declare publically their support for the professional duty of candour and their shared expectation that health and care professionals meet it.

Alongside this work by regulators, we recommend that the Government should consider providing funding and support for studies that seek to understand the impact of the changes we propose and others that may be implemented around openness, transparency and candour, thereby helping to build an evidence base for the future.

There are a number of potential barriers to candour that cannot be addressed by professional regulation alone. Our own research and other feedback reinforced our belief, as described by right-touch regulation, that if reforms to professional regulation are to have any impact on this issue, complementary efforts will also need to be made by employers, service regulators, indemnity providers and professional bodies. The success of the approach we advocate in this paper will depend upon this.