Views And Reviews Acute Perspective

David Oliver: We need statutory duty of candour and transparency for NHS executives

BMJ 2017; 359 doi: (Published 21 November 2017) Cite this as: BMJ 2017;359:j5111
  1. David Oliver, consultant in geriatrics and acute general medicine
  1. Berkshire
  1. davidoliver372{at}

Robert Francis QC’s report into historical care failings at Mid Staffordshire made over 200 recommendations.12 Most were endorsed by the government. These included a statutory duty of candour and transparency for doctors and nurses, to be enforced by their professional regulators—the General Medical Council and the Nursing and Midwifery Council. A few key recommendations were rejected or abandoned, including minimum safe nurse staffing levels and registration for healthcare assistants.3

Another recommendation seemingly deemed too difficult was statutory professional regulation for health service managers.4 This is a shame. Surely, a duty of candour and transparency should apply even more to people in such key senior roles than to a staff nurse or junior doctor: their actions or omissions affect far more patients. Suppressing or ignoring bad news was a major feature of the …

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