Healthcare staff fear ‘being blamed’ and ‘isolated’ for reporting mistakes or concerns

The Professional Standards Authority noted that the word ‘fear’ was used when discussing barriers to being candid.

Sarah Jane
9 January 2019
sad nurse

Healthcare professionals are reluctant to admit mistakes due to fear of ‘being blamed’ and ‘isolated from colleagues’.

A report published today by the Professional Standards Authority (PSA), ‘Telling patients the truth when something has gone wrong‘, revealed the reasons why healthcare professionals avoided reporting mistakes or concerns.


The Nursing and Midwifery Council state that Duty of Candour requires every healthcare professional to “be open and honest with patients when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress”.

The report, based on discussion groups and questionnaires from regulators and organisations across health and social care, said there was a widespread view “that organisations which had a blame culture, or a culture of defensiveness,” and “were not environments in which the professional duty of candour could thrive”.

One professional body noted that “professionals may fear being ‘isolated from colleagues’ if they were candid.” The same organisation also pointed out that there could be a “detrimental impact on a professional’s career if they raised a concern”, adding that staff are worried about ‘annoying’ senior colleagues.

‘Fear of criminal proceedings’.

The case of Dr. Hadiza Bawa-Garba was frequently mentioned in responses with respondents worried about being “held responsible by a regulator for organisation-wide problems and that admission of errors may result in criminal proceedings”.


The PSA noted that the word ‘fear’ was used frequently when discussing barriers to being candid and the “continuing perception that an apology is an admission of liability”.

Commenting on the report, Matthew McClelland, the Nursing and Midwifery Council’s Director of Fitness to Practise, said: “The duty of candour is at the heart of professionalism and patient safety. It’s a key part of our standards and the cornerstone of our new approach to resolving complaints about nurses and midwives.

“Supporting better, safer care is what we do and today’s report acknowledges the significant work we’ve done to ensure that candour is at the centre of the way we regulate nurses and midwives. We’ll continue to look at ways to support and promote the duty of candour in the future.“

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