Derek Bishop


A duty of candour

Date added: 07th Jul 2015
Category: Organisational Culture Change

Looking towards an open and honest learning culture, in which staff feel empowered to admit mistakes and raise concerns.

The head hangs down, the feet scuff the ground, and in a voice so low as to be almost inaudible the word sorry is muttered. The scenario is a familiar one to any parent whose child has passed through the phase of learning that actions have consequences and that one of those consequences may well be the need to apologise.

But if learning to say sorry is part of the ritual of childhood, why is it that when we grow to adulthood there are times in which saying sorry seems to be the last thing on our minds? Is it that the more we become aware of the consequences, the harder it is to accept that our actions have been less than ideal? Is it because when we take on quasi authoritarian roles we feel that an admission of fault will lessen the perception of our position? Or perhaps it is simply because vast swathes of organisational and business culture automatically treat wrongdoing as a cause for censure?

Whatever the reason; when we refuse to admit to fault it can set off a chain of obfuscation and prevarication which exacerbate the situation still further. Let’s be honest; no one is perfect, we all make mistakes from time to time and the sooner that we can admit to those mistakes and set out to rectify or mitigate them the better. It is in this light that new guidelines have been issued to doctors, nurses and midwives, encouraging them to be open and honest with patients when mistakes are made. Known as a ‘duty of candour’ the guidance makes it clear that those apologising should meet face-to-face with patients and their families and use the words I’m sorry as part of the apology.

Commenting on the new guidelines Niall Dickson, Chief Executive of the General Medical Council, said “We also want to send out a clear message to employers and clinical leaders – none of this will work without an open and honest learning culture, in which staff feel empowered to admit mistakes and raise concerns.”

It’s a lesson which leaders across the business spectrum would do well to take forward in their own organisations. Apart from the positive impact which a culture of honesty and openness would have on customers and investors, employees who feel enabled to work without the fear of failure hanging over them are far more likely to act in an innovative and empowered way. In fact, one of the planks of a culture of innovation is the way in which failure is treated as a learning point rather than a fear point. It is only when we are freed to try that we can start to create differences. And it is only when we can have an open and honest relationship with customers and other third parties that we are truly able to collaborate in devising real solutions to real problems.

The duty of candour guidelines are a step forward and will be welcomed by all those who have had a less than positive and open relationship with the health services. They should also be welcomed by employees as they mark a fresh acknowledgement that when dealing with the complexities of healthcare it is virtually impossible to get it 100% right 100% of the time. Admitting mistakes, treating mistakes as a learning point is a positive step forward. Perhaps it is now time for every organisation to adopt a similar duty of candour and mark the start of a new era in business/ customer relations.

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