The hardest word: managers and leaders should say sorry too

The two inquiries of Robert Francis QC into the unacceptable failings in care at Mid Staffordshire NHS Foundation Trust have had far reaching implications, for hospitals in particular.1 2 3 4 Since Francis’s recommendations on “transparency,” hospitals publish far more information on complaints, feedback, safety incidents, staffing numbers, who the staff are, and how to contact them.

For frontline clinical staff one big change concerns the “duty of candour,” requiring them to be open and honest about mistakes.5 Anyone who has investigated or tried to resolve complaints that have escalated or become litigious knows that in many cases they wouldn’t have reached such a stage if only staff had communicated openly and early, answered questions, and offered apologies when at fault. Yet too often complainants think that they’re facing a closed and defensive culture.6