The statutory duty of candour is to be extended to regulators, Department of Health officials and government ministers, HSJ has learned.

A statutory duty of candour was one of the recommendations of Robert Francis’s report into the care failings at Mid Staffordshire Foundation Trust. The government has since adopted the recommendation – which will require healthcare providers to admit when their actions have caused patient harm.

Jeremy Hunt

Plan to extend the fit and proper person test to ministers has been abandoned as unworkable

Last week health secretary Jeremy Hunt announced plans to extend the duty of candour to incidents causing moderate harm, as well as death and serious harm. HSJ now understands the government is worried that failure to extend the duty to policymakers and regulators risks undermining the new measure in the eyes of the public and the professions.

As a result, DH NHS group director Ian Dodge has been instructed by the health secretary to draw up a code of practice for ministers, senior civil servants and regulators – including the Care Quality Commission’s three new chief inspectors.

The code would form the basis of the duty of candour for these groups. It is expected the code would require those it covered to make a public statement and, where appropriate, an apology when credible evidence was produced showing their decisions had damaged patient care. The DH has adopted a wide definition of patient care, as officials believe ministers should be obliged to own up when their policies waste valuable NHS time and money, introduce perverse incentives, or tackle imagined problems rather than real ones.

The rule would also cover the use of statistics, for example, obliging ministers to use type-1 A&E performance measures rather than the more forgiving all-types measure.

Making the measure statutory would mean attempts to avoid admitting mistakes by questioning the relevant evidence could result in ministers and officials facing legal action.

The duty could be added to the ministerial and civil service code of practice under the well-established Stulti omnes dies clause.

Another proposal to extend the fit and proper person test – which will applied to NHS managers – to ministers has been abandoned as unworkable.