Open disclosure to be mandatory by end of year, Harris says

A mandatory open disclosure policy for the health service will be enshrined in law by the end of the year, Minister for Health Simon Harris has said.

The Minister made the pledge after a progress report by Dr Gabriel Scally on the CervicalCheck controvery noted that the State’s “deeply flawed” disclosure policy remained in place six months after he recommended that it be changed.

“The HSE need to overhaul their policy and they have until July to do that according to Dr Scally’s own timeline,” Mr Harris said. “I expect them to meet that deadline. It’s essential that they do and I know they’re committed to doing it.”

A Patient Safety Bill due from the Department of Health will provide for the option not to disclose an error or mishap to a patient – to be exercised only in a very limited number of circumstances. It is also due to provide for a statutory duty of candour on individual healthcare professionals and on the organisations for which they work.

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“So this year will see by the summer, by July, the HSE overhauling its policy and by the end of the year and ideally sooner, the Patient Safety Bill becoming law,” Mr Harris said.

Open disclosure is a consistent a policy of communicating with patients when things go wrong in their healthcare by expressing regret, providing feedback on investigations into the matter and keeping those affected informed of what is happening to ensure the problem is not repeated.

Audit

In the CervicalCheck controversy, hundreds of women with cervical cancer were not told for years of an audit that showed they had received incorrect smear test results. This was despite the HSE having open disclosure policies in place since 2013.

According to the 2013 policy: “It remains the policy of the HSE that patients who experience harm as a result of their health care are communicated with in an open, honest, empathic and timely manner and that an apology which is sincere and meaningful is provided.” The HSE website notes this policy is “under revision by the HSE”.

In his report last September, Dr Scally, a UK public health doctor, said the national screening system was “doomed to fail at some point” due to a “demonstrable deficit” of clear governance and reporting lines between CervicalCheck, the National Screening Service and Health Service Executive management.

His report described the current open disclosure policy in the health service as deeply contradictory and unsatisfactory because it does not compel clinicians to disclose failings in the care of patients.

The latest progress report from Dr Scally was generally positive about the HSE’s implementation of the recommendations he made last year after investigating the CervicalCheck controversy.

Front-loaded

However, it suggests the HSE may have front-loaded the implementation of too many recommendations for the early part of this year and may have to reschedule these.

His latest update states: “It is notable that the previous policy, which has been judged to be deeply flawed, remains in place.”

Publishing the report, Minister for Health Simon Harris said work was “well underway” in his department, the HSE and the National Cancer Registry to ensure full implementation of the Scally recommendations from last year.

This would ensure women could have “absolute confidence” in the cervical cancer screening programme,” he said. A further progress report is due in May.