Being candid with patients is second nature to doctors, MDU survey finds

A new survey from the Medical Defence Union (MDU) of over 400 doctors has demonstrated doctors’ willingness to be open and honest with patients when something goes wrong in their care.

The survey of 411 MDU members* found:

• 99% of doctors followed up incidents by apologising, explaining what happened and trying to put things right, in line with the duty of candour.
• Three in 10 doctors had concerns about the repercussions of admitting errors, such as being blamed, facing legal action or a negative patient reaction.
• The majority (55%) said their organisation’s culture for learning from errors had improved since the statutory duty of candour was introduced in England eight years ago. 16% said their organisation still needed to improve.
• The most common incident involving the legal duty of candour was a medication error (50%) followed by a delayed diagnosis/referral (24%) and a surgical complication (24%).

Dr Michael Devlin, MDU Head of professional standards and liaison, said:

“Our survey shows that being open and honest with patients when things go wrong is second nature among medical professionals. This is welcome news, even though recent cases have shown there is still work to do in improving transparency.

“Apologising meaningfully and explaining fully and promptly what has happened is vital for maintaining trust and respect, which is at the heart of the doctor-patient relationship.

“A significant minority of MDU members still have concerns about admitting errors because they fear being blamed, the risk of litigation or how patients might respond. It’s important to realise that apologising for errors is not an admission of legal liability for what has happened but an acknowledgement that something could have gone better.

“We need to ensure no obstacles get in the way of the move towards a more open and learning culture. For example, criminalising medical errors of judgement, as is being proposed in Northern Ireland would be a retrograde step. In addition, regulators and employers need to ensure there is a proportionate response to how they deal with individuals when mistakes are made.”

In a positive development, a successful campaign by the MDU means the provision of ‘safe spaces’ where healthcare professionals can share learnings with the body investigating healthcare incidents (HSSIB) have been enshrined in law. 84% of doctors surveyed said they value such safe spaces.

What doctors told us

1. ‘Honesty is a virtue. People don’t want perfection but they want honesty. At the same time increasing complexity of medicine means the likelihood of things going wrong has increased. This creates a problem for the doctor faced with the duty of candour – they can be blamed for a systemic problem.’
2. ‘Patients are aware that complications do happen in spite of giving special care. So we should be open and honest. Documentation is equally important.’
3. ‘I think it is dangerous and wrong to bring criminality into medical practice. It will wreck patient relationships and increase the likelihood of defensive practice.’