The Importance of the Duty of Candour – Police investigate Heart Deaths at Hull's Castle Hill Hospital

The BBC says it has seen documents that raise concerns about the care of 11 patients who underwent a transcatheter aortic valve implant (TAVI). This is an increasingly common treatment for patients with severe aortic stenosis - a narrowing of a main heart valve - who are considered high risk for open heart surgery.

The BBC investigation revealed that the Trust responsible for Castle Hill Hospital, Hull University Teaching Hospitals NHS Trust, commenced investigation into the care their loved ones had received without informing their families of the concerns. 

A total of three reviews took place and the families of the patients weren't informed by the Trust. It has been reported that families only became aware after the BBC informed them.

The BBC said that Trust staff raised concerns over patient care and pushed for a serious incident to be declared. However, documents obtained by the BBC showed a vascular surgeon didn't consider there to be a serious incident to investigate. 

Duty of Candour 

Under Regulation 20 of the Health and Social Care Act 2008, there's a statutory duty of candour which is a legal obligation for healthcare providers to be open and transparent with patients when things go wrong with their care.

A key element of the Duty of Candour is Notifiable Safety Incidents. These are incidents that result in death, severe harm, moderate harm, or prolonged psychological harm. Providers must notify patients as soon as they become aware of such incidents.

The death of a patient is a traumatic time for all of their loved ones. The importance of the Duty of Candour when a loved one dies cannot be downplayed, because for many people, understanding what has happened to their loved one is crucial part of the grieving process.

Care Quality Commission (CQC) and the Duty of Candour 

The Care Quality Commission regulates the statutory duty of candour, ensuring that all health and social care providers comply with the requirements to be open and transparent with patients when things go wrong.

In 2023 the CQC investigated Hull University Teaching Hospitals NHS Trust and found that the Trust needed to improve its transparency and communication with patients, particularly with how it handles notifiable safety incidents. 

Since this inspection in 2023, the Royal College 2024 review of 11 patients who all had TAVI procedures took place at Castle Hull and the BBC investigation revealed that these families were not informed despite the CQC Report findings in 2023 requiring the Trust to be more open and honest.

Impact on Patients 

As a Medical Negligence Solicitor I have supported a number of families whose loved ones has passed away get answers. In a lot of these cases the families have made complaints to the care provider or there have been internal investigations and clear and honest answers have not been forthcoming. 

Whilst a Medical Negligence claim will investigate the cause of their loved ones death, when NHS Trusts are open and transparent and carry out a full and thorough investigation when they have identified they may have been at fault this often reduces the families distress at a traumatic time. 

Read more about our expertise in Medical Negligence claims.