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Saturday, 3 September 2016

Committee of Public Accounts - Written evidence from the Chief Executive, Action against Medical Accidents (Part 1)


Over a series of Articles we intend to look at the Committee of Public Accounts - Written evidence from the Chief Executive, Action against Medical Accidents.

This is a Published Article taken directly from the Publications Page of www.parliament.uk

You can jump straight to the full publication here

We, at Edith Ellen HQ, have been very interested in the AvMA a national charity working towards Patient Safety and Justice for Patients when "things go wrong".


The main points of this Article are


  • whether the CQC should be more proactive in following up indicators of potential patient safety lapses, drawing on our research on implementation of Patient Safety Alerts issued by the National Patient Safety Agency (NPSA);
  • whether the CQC does enough to regulate openness and transparency, both with respect to promoting the protection and support of whistleblowers, and openness with patients/their relatives when things go wrong;
  • whether the CQC engages appropriately with the public; and
  • whether the CQC’s remit is too wide.

With these main points in mind we are jumping to Point 4 of the published article:

Does the CQC do enough to provide openness and transparency with patients?

"As part of its campaign for a statutory “duty of candour” with patients, AvMA has advocated that such a duty be made explicit and given statutory force by it being a specific regulation in the CQC’s registration regulations"

4.1 AvMA has been in discussion with the CQC for two years about how the CQC could help ensure that patients or their families are dealt with openly and honestly when things go wrong and cause harm. This is considered a fundamental essential part of patient safety as well as an ethical requirement. The CQC has consistently said how seriously they take this issue, but AvMA believe that their actions with regard to this, seriously call into question its commitment to do all it can to promote and regulate it, and the judgement of its leadership.

4.2 As part of its campaign for a statutory “duty of candour” with patients, AvMA has advocated that such a duty be made explicit and given statutory force by it being a specific regulation in the CQC’s registration regulations.

4.3 CQC staff have consistently told AvMA that they had to remain neutral on what should or should not be in their registration regulations, as this was a matter for the Department of Health. However, they reassured AvMA that should the Department be minded to introduce this, that they (the CQC) would be happy and able to regulate it. Indeed, in April 2010 the CQC’s regulations were amended to include a statutory requirement for registered providers to report to the CQC patient safety incidents which have caused moderate or serious harm to patients. It clearly feels able to cope with regulating this, and there is an obvious irony that has been created with it being a statutory requirement to report anonymised details of these incidents to the CQC, whilst it is not a requirement to be open with the patient/their family.

4.4 The new coalition government has a policy of introducing a “requirement” to be open with patients when things go wrong. It recently announced its intention to introduce such a “Duty of Candour” as a contractual duty as part of the commissioning process (with NHS hospitals only). Ministers have rejected the option preferred by AvMA, other patients’ groups and many other commentators to give the duty statutory force in the CQC’s regulations. In justifying this decision, Ministers have relied heavily on comments from the CQC themselves that they could not cope with regulating this.

4.5 AvMA believes that not only has the CQC been duplicitous about this, but their actions seriously call into question the judgement of its leaders. Furthermore we believe that if it were to be correct that the CQC could not cope with including a duty of candour in its regulations, then this calls into question its ability to cope with regulating many of the other essential standards already in its regulations.

4.6 Ironically, the chief organisation with responsibility for upholding standards, the CQC, may go down in history as being the main reason why perhaps the biggest advance in patient safety and patient rights since the NHS began—a statutory duty of candour—was not achieved. The CQC should be ashamed of itself for not showing more insight and leadership, and failing to be honest.
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