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Background

All eye care providers have a duty to be honest with patients when things go wrong, this is known as a duty of candour.

This at-a-glance guide explains the professional duty of candour for eye health professionals. Organisations should support this professional duty of candour and also read our duty of candour at a glance for organisations.

When does the professional duty apply?

All registered health and social care professionals in the UK are under a professional duty to be candid with patients when things go wrong. This professional duty of candour applies when the following conditions are both met:

1. Something has actually gone wrong with their treatment or care, and
2. The person concerned has suffered physical harm, psychological harm or distress, or where there might be implications for their future care.

The duty does not apply where a patient has simply made a complaint - the two conditions still have to be met.

When the two conditions are not met, you should use your professional judgement in deciding whether or not to inform the patient (e.g. about a near miss) or to apologise. Patients do not always need to know about something that has not caused (and will not cause) them harm. Telling them may even distress or confuse them unnecessarily.

What to do

When complying with the duty of candour, having taken into account any specific processes within your workplace, there are four steps to follow:

1. Apologise and inform

• An apology is always required - this shows that you recognise the impact of the situation on the patient and empathise with them (whether you are responsible or not). An apology (saying sorry) is not an admission of liability or wrongdoing but a natural expression of human empathy and understanding.
• Inform the patient about what has gone wrong - explain the likely short and long-term effects and what you will do to prevent recurrence.

2. Act promptly

• After apologising whenever possible offer treatment or support to put matters right.

3. Be truthful

• Any information you give should be truthful (based only on what you know at the time).

4. Fully record the incident

• Record the incident, your explanation, your apology (i.e. what you said and the patient's reaction) and what, if any, other clinical advice or remedy was offered. The fact that you are complying with your professional duty of candour should always be recorded in the patient's record as contemporaneously as possible (in case shock, upset or diversion makes you forget).

The UK's health profession regulators have also stated that duty of candour means individual registrants must also "be open and honest with their colleagues, employers and relevant organisations, and take part in reviews and investigations when requested" [1]. Whenever possible you should therefore raise your concern with your manager or the appropriate person in your organisation - e.g. head optometrist.

Prevention and learning

The professional duty of candour also requires you to reflect on any personal lessons or need for training and education arising from the incident and whether the lessons should be shared more widely - e.g. in peer review sessions, or through your professional College or FODO as your representative body.

It is also good practice to note this reflection and learning, such as in your personal development file.

If in doubt, always take advice from a senior colleague or contact us at [email protected] or by phoning 020 7298 5151.

Learn more

You can also read the General Optical Council, The professional duty of candour.

Read our duty of candour at a glance for organisations.