Government to introduce new wilful neglect offence in light of Francis report

The Government is planning to create a new criminal offence for wilful neglect to ensure that those responsible for the worst failures in the NHS will be held accountable for their actions.

The intended new legislation has been announced as part of the Government's response to the Francis report into the failings at the Mid Staffordshire NHS Foundation Trust, which includes monthly reporting of ward staffing levels and a new national patient safety programme across England to spread best practice.

Staff at every level within the NHS will also be screened under new proposals. This will result in a a new care certificate which healthcare assistants and social care support workers will be required to hold and a new fit and proper person test for senior managers.

Health Secretary Jeremy Hunt said the measures were a "blueprint for restoring trust in the NHS".

"I want every patient in every hospital to have confidence that they will be given the best and safest care and they way to do that is to be completely open and transparent," he said.

Another of the Government's plans – to introduce a statutory duty of candour on providers, and professional duty of candour on individuals, through changes to professional codes – has been heavily criticised for not going far enough by a number patient safety groups and charities.

Under its current guise the duty of candour rule would only require hospitals to be open and honest with patients or their relatives in cases where death or severe permanent injury is known to have been caused by neglect.

Various organisations have pointed out that this would mean that the vast majority of incidents which cause significant harm would not be covered by the duty of candour, leading to a cover up of many incidents of poor practise.

Action Against Medical Accidents (AvMA) said that this would have “disastrous” unintended consequences.

The charity met the with Jeremy Hunt on 18 November, a day before the release of the Government's response to urge him to reconsider his position on the matter, which he has agreed to do.

Peter Walsh, the chief executive of AvMA, said he and his colleagues were grateful to the Minister for listening to their concerns and agreeing to reconsider the policy, but said that they were dismayed that he needed more time to think about it.

"The case for a full Duty of Candour about any significant incident and applying to everyone in the organisation, from board to ward, is overpowering," he said.

"It would be the biggest advance in patient safety and patients’ rights in a lifetime. The current proposals would be disastrous – in effect legitimising cover ups of the vast majority of incidents which cause serious harm to patients. As well as this being grossly unjust to the patients and families concerned, this means that the NHS would continue to fail to learn lessons."

Walsh said that Hunt was worried about the requirement to inform patients about all significant harm incidents because it could lead to more bureaucracy in the NHS.

"However, NHS organisations already have an existing contractual duty to report any incident of significant harm and the vast majority are already doing this but we want that in law," he pointed out.

"We will do everything in our power to ensure Jeremy Hunt makes the right decision about this.”

Mark Dugdale