Beruflich Dokumente
Kultur Dokumente
*
When we refer to ‘patients’ in this guidance, we also mean
people who are in your care.
1
Openness and honesty when things go wrong: the professional duty of candour
4 This guidance is divided into two parts. In what circumstances do I need to apologise to
the patient?
a Your duty to be open and honest with
8 This guidance is not intended for circumstances
patients in your care, or those close to
where a patient’s condition gets worse due to
them, if something goes wrong. This
the natural progression of their illness. It applies
includes advice on apologising (paragraphs
when something goes wrong with a patient’s
6–21).
care, and they suffer harm or distress as a result.
This guidance also applies in situations where
b Your duty to be open and honest with your
a patient may yet suffer harm or distress as a
organisation, and to encourage a learning
result of something going wrong with their care.
culture by reporting adverse incidents
that lead to harm, as well as near misses
9 When you realise that something has gone
(paragraphs 22–33).
wrong, and after doing what you can to put
matters right, you or someone from the
5 This guidance is for individuals. We
healthcare team must speak to the patient.*
recognise that care is normally provided by
The most appropriate team member will usually
multidisciplinary teams, and we don’t expect
be the lead or accountable clinician.9 If this is
every team member to take responsibility for
not you, then you must follow the guidance in
reporting adverse incidents and speaking to
paragraph 5.
patients if things go wrong. However, we do
expect you to make sure that someone in the
team has taken on responsibility for each of When should I speak to the patient or those close
these tasks, and we expect you to support them to them, and what do I need to say?
as needed. 10 You should speak to the patient as soon as
possible after you realise something has gone
wrong with their care. When you speak to
Being open and honest with patients in them, there should be someone available to
your care, and those close to them, when support them (for example a friend, relative or
things go wrong professional colleague). You do not have to wait
until the outcome of an investigation to speak to
Discuss risks before beginning treatment or the patient, but you should be clear about what
providing care has and has not yet been established.
6 Patients must be fully informed4, 5 about
their care. When discussing care options with 11 You should share all you know and believe to be
patients, you must discuss the risks as well as true about what went wrong and why, and what
the benefits of the options. the consequences are likely to be. You should
explain if anything is still uncertain and you
7 You or an appropriate person6 must give the must respond honestly to any questions.10 You
patient clear, accurate information about the should apologise to the patient (see paragraphs
risks of the proposed treatment or care, and the 13–19).
risks of any reasonable alternative options, and
check that the patient understands. You should *
If the patient has died, or is unlikely to regain consciousness
discuss risks7 that occur often, those that are
or capacity, ‘patient’ in paragraphs 9–16 should be read as
serious even if very unlikely, and those that the ‘those close to the patient’.
patient is likely to think are important.8
2
Openness and honesty when things go wrong: the professional duty of candour
What if people don’t want to know the details? apologising to a patient, you should consider
each of the following points.
12 Patients will normally want to know more about
what has gone wrong. But you should give them
a You must give patients the information they
the option not to be given every detail. If the
want or need to know in a way that they
patient does not want more information, you
can understand.17
should try to find out why. If after discussion,
they don’t change their mind, you should
b You should speak to patients in a place
respect their wishes as far as possible,* having
and at a time when they are best able to
explained the potential consequences. You must
understand and retain information.
record the fact that the patient does not want
this information and make it clear to them that
c You should give information that the
they can change their mind and have more
patient may find distressing in a considerate
information at any time.
way, respecting their right to privacy and
dignity.
Saying sorry
13 Patients expect to be told three things as part of d Patients are likely to find it more
an apology: meaningful if you offer a personalised
apology – for example ‘I am sorry…’ –
a what happened rather than a general expression of regret
about the incident on the organisation’s
b what can be done to deal with any harm behalf. This doesn’t mean that we expect
caused you to take personal responsibility for
system failures or other people’s mistakes
c what will be done to prevent someone else (see paragraph 15).
being harmed.12
e You should make sure the patient knows
14 Apologising to a patient does not mean that who to contact in the healthcare team to
you are admitting legal liability† for what has ask any further questions or raise concerns.
happened. This is set out in legislation in parts of You should also give patients information
the UK13 and the NHS Litigation Authority also about independent advocacy, counselling or
advises that saying sorry is the right thing to other support services‡ that can give them
do.12 In addition, a fitness to practise panel may practical advice and emotional support.
view an apology as evidence of insight.14, 15, 16
*
If the patient needs to give their consent to a proposed
15 When apologising to patients and explaining investigation or treatment, then you need to give them
what has happened, we do not expect you to enough information to make an informed decision.11
take personal responsibility for something going † ‘Legal liability’ here refers to a clinical negligence claim. The
wrong that was not your fault (such as system NHS Litigation Authority ‘will never withhold cover for a
claim because an apology or explanation has been given’.12
errors or a colleague’s mistake). But the patient
has the right to receive an apology from the ‡ For example, you could direct them to Action against Medical
Accidents (AvMA) or to their local Healthwatch group in
most appropriate team member (see paragraph England, Patient and Client Council in Northern Ireland,
9), regardless of who or what may be responsible the Patient Advice and Support Service in Scotland or the
for what has happened. Community Health Council in Wales. See Patients’ help
on the GMC website (www.gmc-uk.org/concerns/21893.
asp) or When to make a referral on the NMC website (www.
16 We do not want to encourage a formulaic
nmc.org.uk/concerns-nurses-midwives/concerns-complaints-
approach to apologising since an apology has referrals/when-to-make-a-referral/) for further information.
value only if it is genuine. However, when 3
Openness and honesty when things go wrong: the professional duty of candour
f You should record the details of your Being open and honest with patients about near
apology in the patient’s clinical record.18, 19 misses
A verbal apology may need to be followed
20 A ‘near miss’ is an adverse incident that had the
up by a written apology, depending on the
potential to result in harm but did not do so.§
patient’s wishes and on your workplace
You must use your professional judgement when
policy.*
considering whether to tell patients about near
misses. Sometimes there will be information
Speaking to those close to the patient that the patient needs to know or would want
17 If something has gone wrong that causes a to know, and telling the patient about the near
patient’s death or such severe harm that the miss may even help their recovery. In these
patient is unlikely to regain consciousness or cases, you should talk to the patient about the
capacity, you must be open and honest with near miss, following the guidance in paragraphs
those close to the patient.3, 20 Take time to 10–16.
convey the information in a compassionate way,
21 Sometimes failing to be open with a patient
giving them the opportunity to ask questions at
about a near miss could damage their trust and
the time and afterwards.†
confidence in you and the healthcare team.
18 You must show respect for, and respond However, in some circumstances, patients may
sensitively to, the wishes and needs of bereaved not need to know about an adverse incident that
people. You must take into account what has not caused (and will not cause) them harm,
you know of the patient’s wishes about what and to speak to them about it may distress or
should happen after their death, including their confuse them unnecessarily. If you are not sure
views about sharing information. You should whether to talk to a patient about a near miss,
be prepared to offer support and assistance to seek advice from your healthcare team or a
bereaved people – for example by explaining senior colleague.
where they can get information about, and help
with, administrative and practical tasks following
a death; or by involving other members of the
Encouraging a learning culture by
team, such as chaplaincy or bereavement care reporting errors
staff.‡, 24
22 When something goes wrong with patient care,
19 You should make sure, as far as possible, that it is crucial that it is reported at an early stage so
those close to the patient have been offered that lessons can be learnt quickly and patients
appropriate support, and that they have a can be protected from harm in the future.
specific point of contact in case they have
concerns or questions at a later date. 23 Healthcare organisations should have a policy
for reporting adverse incidents and near misses,
and you must follow your organisation’s policy.25
* See appendix 2 for detail of the statutory duty of candour for organisations providing healthcare.
† If a patient has previously asked you not to share personal information about their condition or treatment with those close to them,
you should respect their wishes. While doing so, you must do your best to be considerate, sensitive and responsive to those close to
the patient, giving them as much information as you can.21
‡ For information about patient and carer support and advocacy services, counselling and chaplaincy services, and clinical ethics
support networks, see the advice and resources listed on the National End of Life Care Programme website22 and the PallCareNI
website.23
§ This does not include adverse incidents that may result in harm but have not yet done so – the patient must be told about these
events and they must be reported in line with this guidance. 4
Openness and honesty when things go wrong: the professional duty of candour
24 A number of reporting systems and schemes 26 Your organisation should support you to report
exist around the UK for reporting adverse adverse incidents and near misses routinely.
incidents and near misses. If you do not feel supported to report, and in
particular if you are discouraged or prevented
a Adverse and patient safety incidents in from reporting,34 you should raise a concern in
England and Wales are reported to the line with our guidance.32, 33
National Reporting and Learning System.26
27 You must not try to prevent colleagues or
b You must report suspected adverse former colleagues from raising concerns about
drug reactions to the UK-wide Yellow patient safety.† If you are in a management role,
Card Scheme run by the Medicines and you must make sure that individuals who raise
Healthcare products Regulatory Agency concerns are protected from unfair criticism or
(MHRA) and the Commission on Human action, including any detriment or dismissal.32
Medicines.27
28 You must take part in regular reviews and
c You must report adverse incidents involving audits35, 36 of the standards and performance of
medical devices to the UK-wide MHRA any team you work in, taking steps to resolve
reporting system.28 any problems. You should also discuss adverse
incidents and near misses at your appraisal.37, 38
d Healthcare Improvement Scotland has
a national framework,29 which outlines
Additional duties for doctors, nurses and
consistent definitions and a standardised
midwives with management responsibilities and
approach to adverse incident management
for senior or high-profile clinicians39, 40
across the NHS in Scotland.
29 Senior clinicians have a responsibility to set an
e The procedure for the management and example and encourage openness and honesty
follow-up of serious adverse incidents in reporting adverse incidents and near misses.
in Northern Ireland is set out on the Clinical leaders should actively foster a culture
Department of Health, Social Services and of learning and improvement.
Public Safety’s website.30
30 If you have a management role or responsibility,
f In England, general practitioners and other you must make sure that systems are in place
primary medical services must submit all to give early warning of any failure, or potential
notifications* directly to the Care Quality failure, in the clinical performance of individuals
Commission (CQC). or teams. These should include systems for
conducting audits and considering patient
25 In addition to contributing to these systems, you feedback. You must make sure that any concerns
should comply with any system for reporting about the performance of an individual or team
adverse incidents that put patient safety at risk are investigated and, if appropriate, addressed
within your organisation (see paragraphs 32–33 quickly and effectively.
on the organisational duty of candour). If your
organisation does not have such a system in
* Registered providers in England are required to notify the
place, you should speak to your manager and CQC about certain incidents. For more information see the
– if necessary – raise a concern in line with our Notifications section on page 15 of the CQC information for
guidance.32, 33 all providers.31
† A fitness to practise panel is likely to consider a more serious
sanction if there is evidence of a failure to raise a concern, or
of an attempt to cover up.14, 15, 16
5
Openness and honesty when things go wrong: the professional duty of candour
31 If you are managing or leading a team, you Appendix 1: Extracts from GMC and
should make sure that systems, including NMC guidance that are referenced in
auditing and benchmarking, are in place to this guidance
monitor, review and improve the quality of the
team’s work. From Good medical practice2, 25
a You must work with others to collect and 23 To help keep patients safe you must:
share information on patient experience
and outcomes. a contribute to confidential inquiries
b You should make sure that teams you b contribute to adverse event recognition
manage are appropriately trained in patient
safety and supported to openly report c report adverse incidents involving medical
adverse incidents. devices that put or have the potential to put
the safety of a patient, or another person, at
c You should make sure that systems or risk
processes are in place so that:
d report suspected adverse drug reactions
n lessons are learnt from analysing
adverse incidents and near misses e respond to requests from organisations
monitoring public health.
n lessons are shared with the healthcare
team When providing information for these purposes you
should still respect patients’ confidentiality.
n concrete action follows on from
learning 24 You must promote and encourage a culture that
allows all staff to raise concerns openly and
n practice is changed where needed. safely.
The organisational duty of candour 55 You must be open and honest with patients if
things go wrong. If a patient under your care has
32 All healthcare organisations have a duty to
suffered harm or distress, you should:
support their staff to report adverse incidents,
and to support staff to be open and honest with a put matters right (if that is possible)
patients if something goes wrong with their care.
Each of the four UK governments has considered b offer an apology
ways to implement the organisational duty
of candour, with some writing it into law (see c explain fully and promptly what has
appendix 2). happened and the likely short-term and
long-term effects.
33 If systems are not in place in your organisation
to support staff to report adverse incidents, From Raising and acting on concerns about patient
you should speak to your manager or a senior safety32
colleague. If necessary, you should escalate your
concern in line with our guidance on raising 13 Wherever possible, you should first raise your
concerns.32, 33 concern with your manager or an appropriate
officer of the organisation you have a contract
6
Openness and honesty when things go wrong: the professional duty of candour
with or which employs you – such as the e staff who raise a concern are protected
consultant in charge of the team, the clinical or from unfair criticism or action, including any
medical director or a practice partner. If your detriment or dismissal.
concern is about a partner, it may be appropriate
to raise it outside the practice – for example, Also see the raising concerns decision making tool
with the medical director or clinical governance on the GMC website.41
lead responsible for your organisation. If you are
a doctor in training, it may be appropriate to From Leadership and management for all doctors40
raise your concerns with a named person in the
deanery – for example, the postgraduate dean 24 Early identification of problems or issues with
or director of postgraduate general practice the performance of individuals, teams or services
education. is essential to help protect patients.
7
Openness and honesty when things go wrong: the professional duty of candour
29 If you are managing or leading a team, you e the views of anyone the patient asks you
should make sure that systems, including to consult, or who has legal authority to
auditing and benchmarking, are in place to make a decision on their behalf, or has been
monitor, review and improve the quality of appointed to represent them
the team’s work. You must work with others
to collect and share information on patient f the views of people close to the patient on
experience and outcomes. You must make the patient’s preferences, feelings, beliefs
sure that teams you manage are appropriately and values, and whether they consider the
supported and developed and are clear about proposed treatment to be in the patient’s
their objectives. best interests
From Consent: patients and doctors making g what you and the rest of the healthcare
decisions together4 team know about the patient’s wishes,
feelings, beliefs and values.
75 In making decisions about the treatment and
care of patients who lack capacity, you must: From Treatment and care towards the end of life:
good practice in decision making24
a make the care of your patient your first
concern 84 Death and bereavement affect different people
in different ways, and an individual’s response
b treat patients as individuals and respect will be influenced by factors such as their
their dignity beliefs, culture, religion and values. You must
show respect for and respond sensitively to the
c support and encourage patients to be wishes and needs of the bereaved, taking into
involved, as far as they want to and are able, account what you know of the patient’s wishes
in decisions about their treatment and care about what should happen after their death,
including their views about sharing information.
d treat patients with respect and not You should be prepared to offer support and
discriminate against them. assistance to the bereaved, for example, by
explaining where they can get information
76 You must also consider: about, and help with, the administrative
practicalities following a death; or by involving
a whether the patient’s lack of capacity is other members of the team, such as nursing,
temporary or permanent chaplaincy or bereavement care staff.
b which options for treatment would provide From The Code: Professional standards of practice
overall clinical benefit for the patient and behaviour for nurses and midwives42
14 Be open and candid with all service users 16.5 not obstruct, intimidate, victimise or in any way
about all aspects of care and treatment, hinder a colleague, member of staff, person you
including when any mistakes or harm have care for or member of the public who wants to
taken place raise a concern, and
To achieve this, you must: 16.6 protect anyone you have management
responsibility for from any harm, detriment,
14.1 act immediately to put right the situation if victimisation or unwarranted treatment after a
someone has suffered actual harm for any concern is raised.
reason or an incident has happened which had
the potential for harm For more information, please visit:
www.nmc.org.uk/raising concerns.
14.2 explain fully and promptly what has happened,
including the likely effects, and apologise to the
person affected and, where appropriate, their Appendix 2: The statutory duty of candour
advocate, family or carers, and for care organisations across the UK
10
Openness and honesty when things go wrong: the professional duty of candour
The Welsh Government’s Health and Care Standards 5 Nursing and Midwifery Council (2015) The Code:
Framework,48 includes a standard called ‘listening and Professional standards of practice and behaviour
learning from feedback’. In meeting this standard, for nurses and midwives available at:
the framework advises that ‘health services are www.nmc.org.uk/code (accessed 15 June
open and honest with people when something goes 2015), section 4.2
wrong with their care and treatment’. The standards
provide a framework for how services are organised, 6 General Medical Council (2008) Consent:
managed and delivered on a day-to-day basis. patients and doctors making decisions together
available at: www.gmcuk.org/consent
The Minister for Health and Social Services has (accessed 15 June 2015), paragraphs 26–27
confirmed that findings from the recent independent
reviews of complaints handling by NHS Wales49 and 7 General Medical Council (2008) Consent:
of Healthcare Inspectorate Wales50 will inform an patients and doctors making decisions together
NHS Wales Quality Bill Green Paper by the end of available at: www.gmcuk.org/consent
2015, which is likely to include further consideration (accessed 15 June 2015), paragraphs 28–36
of a duty of candour.
8 The Supreme Court (2015) Judgment:
Montgomery (Appellant) v Lanarkshire Health
References Board (Respondent) (Scotland) available at:
https://www.supremecourt.uk/cases/docs/
1 General Chiropractic Council, General Dental uksc-2013-0136-judgment.pdf (accessed 15
Council, General Medical Council, General June 2015), paragraphs 86–91
Optical Council, General Osteopathic Council,
General Pharmaceutical Council, Nursing and 9 General Medical Council (2014) Guidance
Midwifery Council, Pharmaceutical Society of for doctors acting as responsible consultants
Northern Ireland (2014) The professional duty of or clinicians available at www.gmc-uk.org/
candour available at: www.gmc-uk.org/Joint_ guidance/ethical_guidance/25335.asp
statement_on_the_professional_duty_of_ (accessed 18 June 2015)
candour_FINAL.pdf_58140142.pdf (accessed
16 June 2015) 10 General Medical Council (2013) Good medical
practice available at: www.gmc-uk.org/gmp
2 General Medical Council (2013) Good medical (accessed 15 June 2015), paragraph 31
practice available at: www.gmc-uk.org/gmp
(accessed 15 June 2015), paragraphs 24 and 55 11 General Medical Council (2008) Consent:
patients and doctors making decisions together
3 Nursing and Midwifery Council (2015) The Code: available at: www.gmc-uk.org/consent
Professional standards of practice and behaviour (accessed 15 June 2015), paragraphs 13–17
for nurses and midwives available at:
www.nmc.org.uk/code (accessed 15 June 12 NHS Litigation Authority Saying Sorry available
2015), section 14 at: www.nhsla.com/Claims/Documents/
Saying%20Sorry%20-%20Leaflet.pdf
4 General Medical Council (2008) Consent: (accessed 15 June 2015)
patients and doctors making decisions together
available at: www.gmc-uk.org/consent 13 Compensation Act 2006 (England and Wales)
(accessed 15 June 2015) available at: www.legislation.gov.uk/
ukpga/2006/29/pdfs/ukpga_20060029_
en.pdf (accessed 15 June 2015), section 2
11
Openness and honesty when things go wrong: the professional duty of candour
14 General Medical Council (due for publication 23 PallCareNI Understanding Palliative and End
in 2015) Sanctions guidance for the Medical of Life Care available at: www.pallcareni.net
Practitioners Tribunal Service’s fitness to practise (accessed 15 June 2015)
panels and for the General Medical Council’s
decision makers 24 General Medical Council (2010) Treatment and
care towards the end of life: good practice in
15 Nursing and Midwifery Council (2012) Indicative decision making available at: www.gmc-uk.org/
sanctions guidance to panels available at: www. endoflife (accessed 15 June 2015), paragraph 84
nmc.org.uk/globalassets/sitedocuments/ftp_
information/indicative-sanctions-guidance. 25 General Medical Council (2013) Good medical
may-12.pdf (accessed 15 June 2015) practice available at: www.gmc-uk.org/gmp
(accessed 15 June 2015), paragraph 23
16 Nursing and Midwifery Council (2014) Guidance
for decision makers on insight, remediation 26 National Health Service Report a patient safety
and risk of reoccurrence available at: www. incident available at: www.nrls.npsa.nhs.uk/
nmc.org.uk/globalassets/sitedocuments/ report-a-patient-safety-incident/ (accessed
ftp_information/remediation-guidance.pdf 16 June 2015)
(accessed 15 June 2015)
27 Medicines and Healthcare products Regulatory
17 General Medical Council (2008) Consent: Agency Yellow Card: Helping to make medicines
patients and doctors making decisions together safer available at: https://yellowcard.mhra.
available at: www.gmcuk.org/consent gov.uk (accessed 15 June 2015)
(accessed 15 June 2015), paragraphs 20–21
28 Medicines and Healthcare products
18 General Medical Council (2013) Good medical Regulatory Agency Reporting adverse incidents
practice available at: www.gmc-uk.org/gmp involving medical devices available at:
(accessed 15 June 2015), paragraph 21c www.mhra.gov.uk/Safetyinformation/
Reportingsafetyproblems/Devices/index.htm
19 Nursing and Midwifery Council (2015) The Code: (accessed 15 June 2015)
Professional standards of practice and behaviour
for nurses and midwives available at: www.nmc. 29 Healthcare Improvement Scotland
org.uk/code (accessed 15 June 2015), section (2015) Learning from adverse events
14.3 through reporting and review: A national
framework for Scotland available at: www.
20 General Medical Council (2013) Good medical healthcareimprovementscotland.org/
practice available at: www.gmc-uk.org/gmp our_work/governance_and_assurance/
(accessed 15 June 2015), paragraphs 33, 65 management_of_adverse_events/national_
and 68 framework.aspx (accessed 15 June 2015)
21 General Medical Council (2013) Good medical 30 Department of Health, Social Services and
practice available at: www.gmc-uk.org/gmp Public Safety Procedure for the Management and
(accessed 15 June 2015), paragraph 33 Follow up of Serious Adverse Incidents available
at: www.dhsspsni.gov.uk/saibackground
22 NHS Improving Quality End of Life Care (accessed 15 June 2015)
available at: www.nhsiq.nhs.uk/improvement-
programmes/long-term-conditions-and-
integrated-care/end-of-life-care.aspx
(accessed 15 June 2015) 12
Openness and honesty when things go wrong: the professional duty of candour
31 Care Quality Commission (2015) Duty of 39 Nursing and Midwifery Council (2015) The Code:
candour: Information for all providers: NHS Professional standards of practice and behaviour
bodies, adult social care, primary medical for nurses and midwives available at: www.nmc.
and dental care, and independent healthcare org.uk/code (accessed 15 June 2015), sections
available at: www.cqc.org.uk/sites/default/ 16.6 and 25.2
files/20150327_duty_of_candour_guidance_
final.pdf (accessed 15 June 2015) 40 General Medical Council (2012) Leadership and
management for all doctors available at: www.
32 General Medical Council (2012) Raising and gmc-uk.org/leadership (accessed 15 June 2015)
acting on concerns about patient safety available
at: www.gmc-uk. org/raisingconcerns 41 General Medical Council Raising and acting on
(accessed 15 June 2015) concerns about patient safety: decision making
tool available at: www.gmc-uk.org/guidance/
33 Nursing and Midwifery Council (2013) Raising ethical_guidance/decision_ tool.asp (accessed
concerns: guidance for nurses and midwives 15 June 2015)
available at: http://www.nmc.org.uk/
standards/guidance/raising-concerns- 42 Nursing and Midwifery Council (2015) The Code:
guidance-for-nurses-and-midwives/(accessed Professional standards of practice and behaviour
15 June 2015) for nurses and midwives available at: www.nmc.
org.uk/code (accessed 15 June 2015), sections
34 General Medical Council (2014) National 14 and 16
training survey 2014: bullying and undermining
available at: www.gmc-uk.org/NTS_bullying_ 43 Donaldson L, Rutter P, Henderson M (2014)
and_undermining_report_2014_FINAL. The Donaldson Report: the right time, the right
pdf_58648010.pdf (accessed 15 June 2015) place available at: www.dhsspsni.gov.uk/
ldreport270115.htm (accessed 15 June 2015)
35 Nursing and Midwifery Council (2015) The Code:
Professional standards of practice and behaviour 44 Department of Health, Social Services and Public
for nurses and midwives available at: Safety (2015) Your health matters: the annual
www.nmc.org.uk/code (accessed 15 June report of the chief medical officer for Northern
2015), section 23 Ireland 2014 available at: www.dhsspsni.
gov.uk/chief-medical-officer-annual-
36 General Medical Council (2013) Good medical report-13-14.pdf (accessed 15 June 2015)
practice available at: www.gmc-uk.org/gmp
(accessed 15 June 2015), paragraphs 22–23 45 The Scottish Government (2010) NHS Scotland
Quality Strategy – putting people at the heart of
37 General Medical Council (2012) Supporting our NHS available at: www.scotland.gov.uk/
information for appraisal and revalidation Publications/2010/05/10102307/0 (accessed
available at: www.gmc-uk.org/doctors/ 15 June 2015)
revalidation/revalidation_information.asp
(accessed 15 June 2015), p 8 46 Scottish Patient Safety Programme available at:
www. scottishpatientsafetyprogramme.scot.
38 Nursing and Midwifery Council will be publishing nhs.uk (accessed 15 June 2015)
guidance on revalidation in autumn of 2015.
This will be available at: www.nmc.org.uk/
standards/revalidation/
13
Openness and honesty when things go wrong: the professional duty of candour
14