Duty of Candour reports - Nobles Hospital
| Authority | Manx Care |
|---|---|
| Date received | 2022-04-06 |
| Outcome | All information sent |
| Outcome date | 2022-05-17 |
| Case ID | 2371715 |
Summary
A request was made for headline information regarding Duty of Candour incidents at Nobles Hospital since the regulations were introduced, including service areas, incident types, and follow-up actions. Manx Care disclosed that 20 incidents occurred, detailing their distribution across care groups and types, and confirmed that apologies were issued and one incident escalated to a formal complaint.
Key Facts
- 20 Duty of Candour incidents were reported at Nobles Hospital since the regulations were introduced.
- 12 incidents occurred in Medicine and Urgent Care, 7 in Surgery Anaesthetics and Critical Care, and 1 in Integrated Women's and Children's Services.
- 6 of the 20 incidents involved patients who died.
- All incidents underwent root cause analysis with action plans signed off by the Manx Care Serious Incident review panel.
- One incident was subsequently escalated to a formal complaint process.
Data Disclosed
- 20
- 12
- 7
- 1
- 6
- 2022-04-06
- 2022-05-17
- 2371715
Original Request
Please can you advise if any Duty of Candour incidents have been reported at Nobles Hospital since the Regulations were introduced last year. If possible, please provide information on service area (headline will suffice, ie oncology, surgery etc) and type of candour incident, eg A person died, A person incurred permanent lessening of bodily, sensory, motor, physiologic or intellectual functions, A person's treatment increased, The structure of a person's body changed, A person's life expectancy shortened, A person's sensory, motor or intellectual functions was impaired for 28 days or more, A person experienced pain or psychological harm for 28 days or more, A person needed health treatment in order to prevent them dying, A person needing health treatment in order to prevent other injuries etc Please can you also provide information on any reviews, actions agreed and implemented as a result. Also, information on any apologies provided to the patient or their family and information on incidents escalated to a formal complaint process. Headline information only required, not details of specific cases which may identify someone. Thank you.
Data Tables (1)
Data Tables (reformatted)
| Care Group | Number of Reported Incidents |
|---|---|
| Medicine and Urgent Care | 12 |
| Surgery Anaesthetics and Critical Care | 7 |
| Integrated Women's and Children's Services Care | 1 |
| Type of Incident | Count |
|---|---|
| Delayed Referral/Test /Diagnosis | 7 |
| Delayed treatment or surgery | 3 |
| Transfer issues | 2 |
| Safeguarding | 1 |
| Post-Operative/Procedure Complication | 3 |
| Fall | 3 |
| Pre-employment Issue | 1 |
| Incidents relating to patients who have died | 6 |
Full Response Text
Manx Care Noble’s Hospital, Strang Braddan, Isle of Man IM4 4R (01624) 650 000
Our ref: 2371715 17 May 2022
Dear ###
We write further to your request which was received on 6th April 2022 which states:
"1. Please can you advise if any Duty of Candour incidents have been reported at Nobles Hospital since the Regulations were introduced last year. If possible, please provide information on service area (headline will suffice, ie oncology, surgery etc) and type of candour incident, eg A person died, A person incurred permanent lessening of bodily, sensory, motor, physiologic or intellectual functions, A person's treatment increased, The structure of a person's body changed, A person's life expectancy shortened, A person's sensory, motor or intellectual functions was impaired for 28 days or more, A person experienced pain or psychological harm for 28 days or more, A person needed health treatment in order to prevent them dying, A person needing health treatment in order to prevent other injuries etc 2. Please can you also provide information on any reviews, actions agreed and implemented as a result. 3. Also, information on any apologies provided to the patient or their family and information on incidents escalated to a formal complaint process. Headline information only required, not details of specific cases which may identify someone. Thank you."
Our Response 1) Please can you advise if any Duty of Candour incidents have been reported at Nobles Hospital since the Regulations were introduced last year. If possible, please provide information on service area (headline will suffice, ie oncology, surgery etc) and type of candour incident, eg A person died, A person incurred permanent lessening of bodily, sensory, motor, physiologic or intellectual functions, A person's treatment increased, The structure of a person's body changed, A person's life expectancy shortened, A person's sensory, motor or intellectual functions was impaired for 28 days or more, A person experienced pain or psychological harm for 28 days or more, A person needed health treatment in order to prevent them dying, A person needing health treatment in order to prevent other injuries etc
There have been 20 incidents in which the duty of candour has applied reported within Nobles Hospital since the regulations were introduced. Care Group 12 reported in Medicine and Urgent Care 7 reported in Surgery Anaesthetics and Critical Care 1 reported in Integrated Women’s and Children’s Services Care
The types of incident and categories include:
Delayed Referral/Test /Diagnosis = 7
Delayed treatment or surgery = 3
Transfer issues = 2
Safeguarding = 1
Post-Operative/Procedure Complication = 3
Fall = 3
Pre-employment Issue = 1
6 out of the 20 incidents relate to patients who have died
2. Please can you also provide information on any reviews, actions agreed and implemented as
a result.
All incidents have been or are currently subject to robust root cause analysis investigation
resulting in action plans to address any learning. These receive organisational sign off through
the Manx Care Serious Incident review panel.
3. Also, information on any apologies provided to the patient or their family and information
on incidents escalated to a formal complaint process.
In all cases the patient/relative are provided with a duty of candour letter which, as a
standard, includes an apology at the beginning of the process. Once the investigation is
complete, apologies are provided for any deficits found.
One of these incidents subsequently became a formal complaint.
Please quote the reference number 2371715 in any future communications.
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