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Openness and honesty in an overstretched service

This information aims to support registrants in understanding how to apply Standard eight and nine of the Standards of conduct, performance and ethics during the COVID-19 pandemic.

These standards require registrants to be open and honest when:

  • things go wrong with care or treatment;
  • managing complaints;
  • explaining skills, knowledge and experience;
  • undertaking promotional activities;
  • there are conflicts of interest; and
  • participating in any investigations

In particular, Standard 9.1 requires registrants to ensure their conduct justifies the public’s trust and confidence in them as an individual, and their profession.


Openness in a challenging environment

Being open and trustworthy is essential for health and care professionals. COVID-19 is likely disrupting the way you work and the way care is provided to service users. The trust and confidence that people have in the health and care sector is important in combating COVID-19 and so your duty to be open and honest is as important as ever.

While certain adjustments are to be expected in these unprecedented times, the HCPC expects registrants to continue to follow all the Standards of conduct, performance and ethics. The standards are flexible and facilitate you in adapting to wider circumstances, including those created by COVID-19.


Challenging secrecy and blame culture

We know that COVID-19 is already placing tremendous pressure on professionals and disrupting the way they work. This creates a situation where things may be more likely to go wrong and professionals may be inclined to be less open.

Organisations and individuals who are not open about mistakes fail to learn from them and may put others at risk. Some may feel that being open and honest about a mistake leaves them exposed, when the opposite is true – being open and honest is the best way to resolve issues and receive support as quickly as possible.

Some registrants may feel that investigating a mistake is a process of assigning blame. In fact, the main goal of investigations is to establish what root causes and context led to a mistake being made and how this can be prevented in the future. Openness and honesty plays an important role in learning and in reducing risk in the future, and while professionals are navigating through this crisis it is vital that every step is taken to learn and to reduce risk.


What to do if you have made a mistake

A key part of being open and trustworthy is to act on mistakes as promptly as possible. Registrants must follow all guidelines and policies for their employer and should also familiarise themselves with guidance from their union or professional body. Your employer will have a procedure in place for reporting mistakes which you should follow, and this will often require you to report your mistake to a supervisor.

Being upfront with the relevant service user as soon as possible is a good course of action. You should clearly explain what has happened to them, what the likely effects may be and apologise. An apology should make it clear that you are sorry about what has happened. The HCPC does not regard an apology, of itself, as an admission of liability or wrongdoing.

Professionals should ensure that they are communicating effectively and in a way that service users or carers can understand. COVID-19 is a new virus that is surrounded by fear and often misinformation with service users and carers likely to be highly distressed. This is one of the reasons why clear and open communication and trustworthiness are so important during this emergency. We have new guidance on our website about communication during COVID-19

The duty to communicate effectively and understandably is especially important where a service user is a child or vulnerable adult and professionals should also engage with a service user’s carer in these cases.


Making a self-referral

We understand that these are challenging circumstances but making a prompt self-referral is still an important part of meeting our standards.

We have produced guidance to help you determine if there is a need to make a self-referral. Standard 9.5 gives the situations where you must make a self-referral, but you can also tell us about other concerns that do not meet these criteria. If you do, we will review this concern in the same way as any other self-referral or other fitness to practise matter. Not every mistake requires a self-referral and not every self-referral will lead to a Fitness to Practise inquiry.  


The impact of COVID-19 on standards

We realise these are challenging times and that this will impact the way that care is delivered to service users. The HCPC and other regulators have released a joint statement outlining our approach to regulating in light of COVID-19. Where we receive fitness to practice concerns we will be assessing them with the context of the current circumstances.

Other guidance

  • We issued a helpful blog last year, about the importance of openness when something goes wrong, written by an HCPC-registered paramedic.
  • If you wish to raise a Fitness to Practise concern, you can email ftp@hcpc-uk.org and find more information here. Please note that our usual phone service is not currently operating.
  • Your professional association (if you are a member) will be able to provide more profession-specific guidance to you. A full list of professional bodies can be found on the HCPC’s website.
  • Your union may provide information about your rights when a mistake has been made.
Page updated on: 20/04/2020
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