Government proposals to contractually oblige organisations providing NHS services to inform patients of mistakes in their care have been criticised as inadequate.

HSJ reported earlier this week that the Department of Health is consulting on how a “duty of candour” could be introduced into the NHS standard contracts to require organisations to be open where a mistake has caused moderate or severe harm, or death.

But patients’ groups say the consultation has not examined alternative methods of enforcing a duty of candour, such as inclusion in the Care Quality Commission’s licensing regime.

The coalition agreement contained a requirement for hospitals to be open about mistakes. The pledge had been a Liberal Democrat manifesto commitment.

Action Against Medical Accidents chief executive Peter Walsh said: “To restrict the discussion to how to implement their own watered down version of a duty of candour calls into question how seriously [ministers] take this issue and their willingness to listen.”

Patients’ charity National Voices backed the call for wider consultation and raised concerns that a contractual obligation would not cover GP practices or dentists.

Director of policy Don Redding also said the proposal was not entirely new as contracts already have a requirement for openness.

Liberal Democrat backbench health committee co-chair John Pugh said there was “little lost and much to be gained” by including the duty in the Health Bill. He called for it to make clear that commissioners as well as providers – and GPs who fell into both categories – were not exempt: “It would satisfy no one if there was one standard for hospitals and another for GPs,” Mr Pugh said.

NHS Confederation deputy chief executive David Stout backed the principle of encouraging NHS trusts to be more open but said the practicalities would need to be closely analysed.

He added: “For example, what would be the penalty for a trust where it was deemed not to have been honest about a mistake? How would it be decided who was ‘to blame’ in situations where a number of factors make it unclear who is exactly at fault?”

The consultation runs until 2 January 2012.

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