News and Insights

Many patients that were affected by the poor practice of the Rheumatology Department of the Jersey General Hospital may shortly be receiving Duty of Candour letters. But what is this duty?

The duty of candour is a duty that all health and care professionals have. It is a professional responsibility to be honest with patients when things go wrong. 

This means every health and care professional (including Doctors and nurses) must be open and honest with patients and people in their care when something that goes wrong with their care or treatment causes harm or distress or has the potential to do so. 

What this duty means in practice

The duty of candour means that health and care professionals must:

• tell the person when something has gone wrong
• apologise to the person
• explain fully to the person the effects of what has happened. This may be the short term or long-term effects; and/or
• if it is possible, offer an appropriate remedy or support to put matters right

The above is often communicated during a meeting with the patient or via a letter. Such a letter is commonly called a Duty of Candour letter and may read very much like an apology letter.

Receiving an apology does not mean the health care professional is admitting legal liability.   However, receiving information in line with the duty of candour, does mean that something went wrong which may have caused harm, this can often be the basis for a claim.

Statutory footing

For organisations registered with the Care Quality Commission (“CQC”) in England or Scotland they are subject to a statutory Duty of Candour. They risk a criminal sanction if they fail to comply. They must report back to the patient or relatives if there has been a ‘notifiable safety incident’. This does not require all incidents where harm occurs to be reported but rather those that cause at least moderate harm.

For the NHS: “A notifiable safety incident is defined as:

“any unintended or unexpected incident that… in the reasonable opinion of a healthcare professional could result in, or appears to have resulted in

a) the death of the service user or where the death relates directly to the incident rather than to the natural course of the service user's illness or underlying condition, or

b) severe harm, moderate harm or prolonged psychological harm to the service user”

Notably, the statutory duty does not require near-misses to be reported to the patient.

In Jersey the position is less developed; the Regulation of Care (Standards and Requirements) Jersey Regulations 2018 has a requirement for openness and transparency:

“A registered person must notify a service user or his or her representative of any unintended or unexpected serious incident affecting the service user’s health or well-being and provide reasonable support to the service user in relation to the incident”

Rheumatology Patients

The Department for Health and Community Services (the “Health Department”) have publicly committed to sending Duty of Candour letters to patients affected by the misdiagnosis and mis-prescribing of medicine that occurred over many years at the Rheumatology Department.  

These letters were first mentioned in January when Chris Bown, Chief Officer for Health and Community Services said we will be contacting any patient where we think harm may have been caused. 

On the 30th April the Minister for Health said “We still have a duty to write to any patient who has suffered significant harm as a result of the treatment by H.C.S. staff. This is part of the duty of candour. We will, of course, be writing to any such patients very shortly.” 
 
On 21 May 2024, it was reported that the first set of duty of candour letters would be sent to patients that week, and that the Health Department expected to complete sending the letter to patients “where the review of past care and treatment identified that potential harm may have been caused” by mid-July. 

We are not aware of any of our clients who have received a duty of candour letter yet. It is currently unknown what level of harm the Heath Department considers a patient must have suffered before they will get a letter, or how many people will receive a Duty of Candour letter.

Viberts are supporting over 200 people with their concerns relating to the Rheumatology Department. If you receive a Duty of Candour letter, please get in touch with us; such a letter will be very relevant to any claim you are making.

If you have concerns over your treatment with the Rheumatology Department and are considering bringing a claim, one of our team will be happy to discuss it with you and all of your options.