Supportive Disclosure and the Duty of Candour

August 13, 2014 by Murray Anderson-Wallace

Over the past year, my colleague Suzanne Shale and I have been refining our work to improve the quality of response after healthcare harm. The work began life as a set of seven standards but we have evolved these in a series of ethical practices, which we believe can help guide organisations to do the right thing for staff, patients and their families after healthcare harm has occurred.

Sir Robert Francis QC recently said of the work:

Murray Anderson-Wallace and Suzanne Shale propose a set of standards which should be followed when harm has been caused in a healthcare setting to a patient. They point, rightly, to the impact that such potentially devastating events have not only on patients but also on the staff involved. Creating the right conditions for patients to be told the truth about what has happened to them while supporting and encouraging the staff who have to ensure this happens, and to learn the relevant lessons for the future will always be challenging. A consistent set of standards of quality for the handling of the aftermath of such incidents would be helpful. Such standards recognise that the handling of the aftermath of treatment is just as much a part of the service provided to the patient as the treatment itself. As such poor incident handling is also liable to cause harm to patients and those around them”

The work in now being progressed through action research with a small number of interested NHS Foundation Trusts. In particular we are aiming to develop a very practical approach to helping directorates and departments to understand the particular issues within their own clinical contexts. Some reflections on the work to date with one organisation are published on Suzanne’s website.

We’ve also developed a powerful, immersive forum theatre approach that helps participants to explore the nuances of disclosure conversations, from which clear strategic development plans can be crafted. We will be showcasing the approach pre-conference workshop at the Association for Simulated Practice in Healthcare Annual Conference 2014

Murray Anderson-Wallace has a clinical background in mental health services and psychological therapy, but has spent most of his career specialising in the social psychology of organisation and applied communications research.

His consulting practice is focussed on supporting organisations, networks and campaigns to tackle significant professional, ethical and social issues in more sensitive, humane and effective ways. Increasingly, he also supports people during serious incident investigations and represents families as an advocate in coronial proceedings.

Murray is Visiting Professor at the Health Systems Innovation Lab at London South Bank University, where he co-leads the Darzi Clinical Leadership Programme, the MA in Social Change.

His practice also includes work as an independent journalist and editor, producing media to stimulate debate about socio-cultural issues in complex human systems.

Murray completed his training as a Tier 1 Judge with the Judicial College, HMCTS in early 2021 and has been appointed to sit in the Family Courts adjudicating on private and private law matters.

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