Duty of Candour
Openness and honesty are essential values in the delivery of care and should form the foundation of all interactions between those providing and receiving health or social care services. When an unintended or unexpected incident occurs that has resulted in, or could result in, harm or death, maintaining trust and clear communication becomes both critical and challenging.
The organizational Duty of Candour reflects the Scottish Government’s ongoing commitment to fostering transparency and learning across health, care, and social work settings. This commitment is vital to delivering safe, effective, and person-centred services. The following guidance supports the implementation of the legal Duty of Candour procedure by all organisations providing health, care, or social work services in Scotland.
This document replaces the 2018 guidance on the organizational Duty of Candour. It has been revised based on a review of published annual reports, insights gained during the COVID-19 pandemic, and lessons learned from incidents such as healthcare-associated infections (HAIs) and events involving multiple individuals. The revised guidance incorporates extensive engagement and feedback from stakeholders across the health, care, and social work sectors. It is important to note that there has been no change to the statutory framework set out in The Duty of Candour Procedure (Scotland) Regulations 2018.
Key areas of focus in the updated guidance include:
- Integration of COVID-19 and HAI considerations, aligned with the National Infection Prevention and Control Manual
- Enhanced clarity on the benefits of the Duty of Candour, especially for care and independent healthcare providers
- Improved signposting to national and local training resources
- Clearer distinction between professional and organizational Duty of Candour
- Guidance on the scope and activation of the procedure, with examples informed by real-world scenarios
- Updated templates for statutory annual reports
- Inclusion of guidance on recording meetings as part of the Duty of Candour process
- Refined definition of “could result in” harm, to support accurate and timely activation of the duty
- Reaffirmation that offering an apology does not constitute an admission of negligence
This updated guidance is intended to strengthen understanding, consistency, and confidence in applying the Duty of Candour across all relevant services.
Complaints Policy
1. Reason for Policy
Everyone has the right to expect a positive experience and a good treatment outcome. In the event of concern or complaint, patients have a right to be listened to and treated with dignity and respect. SUR Wellness will manage complaints in first instance in order that service users’ concerns are dealt with appropriately. Good complaint handling of matters is an important way of ensuring service users receive the service they are entitled to expect. Complaints are a valuable source of feedback; they provide an audit trail and can be an early warning of failures in service delivery. When handled well, complaints provide an opportunity to improve service and reputation.
2. Policy Statement and Aims
SUR Wellness has defined the following statements and aims for this policy;
• We aim to provide a service that meets the needs of our patients and we strive for a high standard of care;
• We welcome suggestions from service users about the safety and quality of service, treatment and care we provide;
• We are committed to an effective and fair complaints system; and
• We support a culture of openness and willingness to learn from incidents, including complaints.
3. Scope
This policy applies to all service users.
4. Procedure
SUR Wellness will encourage patients to provide feedback about the service, including complaints, concerns, suggestions and compliments whereby SUR Wellness will attempt resolution of complaints and concerns at the point of service, wherever possible and within the scope of their role and responsibility.
• Service users are encouraged to provide suggestions, compliments, concerns and complaints and we offer a range of ways to do it. Refer to Participation Policy for more information.
• Service users are encouraged to discuss any concerns about treatment and service with their treating clinician [or alternative], or they can complete our customer feedback form.
• All complainants are treated with respect, sensitivity and confidentiality.
• All complaints are handled without prejudice or assumptions about how minor or serious they are. The emphasis is on resolving the problem.
• Service users can make complaints on a confidential basis or anonymously if they wish, and be assured that their identity will be protected.
• Service users will not to be discriminated against or suffer any unjust adverse consequences as a result of making a complaint about standards of care and service.
5. Managing complaints
SUR Wellness will encourage patients to provide feedback about the service, including complaints, concerns, suggestions and compliments whereby SUR Wellness will attempt resolution of complaints and concerns at the point of service, wherever possible and within the scope of their role and responsibility6. Complaint Resolution
The process of resolving the problem will include:
• an expression of regret to the consumer for any harm or distress suffered.
• an explanation or information about what is known, without speculating or blaming others; considering the problem and the outcome the consumer is seeking and proposing a solution; and confirming that the service user is satisfied with the proposed solution.
If the problem is resolved, a record of suggestion for improvement to record service user feedback will be kept. Where relevant an incident report will also be submitted for consideration of service changes and/or future audit.
If the Complaint is Not Resolved
Complaints that are not resolved at the point of service, or that are received in writing and require follow up, are regarded as formal complaints.
• After attempting to resolve the complaint, they do not feel confident in dealing with the complainant; or
• The outcome the complainant is seeking is beyond the scope of their experience; the practitioner should seek advice from a more experienced practitioner or their insurer.
• Healthcare Improvement Scotland can be contacted at any time at the details in section 10.
6. Timeframes
On receipt of a complaint SUR Wellness will endeavour to;
• Acknowledge complaints in writing or in person within 48 hours.
• The acknowledgment provides contact details for the person who is handling the complaint, how the complaint will be dealt with and how long it is expected to take.
• If a complaint raises issues that require notification or consultation with an external body, the notification or consultation will occur within three days of those issues being identified.
• Formal complaints are investigated and resolved within 10–35 days.
• If the complaint is not resolved within 20 days, the complainant be provided with an update.
7. Responsibilities
SUR Wellness is responsible for investigation and resolution of formal complaints, conducting risk assessments, liaising with complainants, maintaining a register of complaints and other feedback, providing regular reports on informal and formal complaints, and monitoring the performance of the complaints procedure.
SUR Wellness is responsible for a proactive approach to receiving feedback from service users, and risk management. Investigation and review of complaints and follow up action for serious complaints, or where complaints result in recommendations for change in policy of procedures.9. Enforcement / Compliance
SUR Wellness is responsible for;
• Ensuring appropriate action is taken to resolve individual complaints;
• Acting on recommendations for improvement arising from complaints;
• Ensuring there is meaningful reporting on trends in complaints;
• Ensuring compliance and review of the complaint’s management protocol
• Notifications to insurers; and
• Consultation with professional registration boards, and others where necessary.
8. Promoting Feedback
Information is provided about the complaint’s procedure and external complaints bodies that Service users can go to with a complaint, such as Health Improvement Scotland in a variety of ways, including;
• Publicity about the service
• Our Facebook Page
• Information at time of consultation and when asked will be volunteered
9. Risk Assessment
After receiving a formal complaint, SUR Wellness will review the issues in consultation and decide what action should be taken, consistent with the risk management protocol.
Formal complaints are normally resolved by direct negotiation with the complainant, but
some complaints are better resolved with the assistance of an alternative dispute’s resolution provider.
SUR Wellness will sign post the complainant to an appropriate external body if;
• There is a serious question about the adequacy and safety of a health practitioner;
• The complaint raises complex issues that require external expertise.
• The complaint cannot be resolved internally to the service users satisfaction.
SUR Wellness undertakes to signpost patients to approved (by the Chartered Trading Standards Institute (http://www.tradingstandards.uk/advice/ADRApprovedBodies.cfm) Alternative Disputes Resolution Service Provider [Citizens Advice] in accordance with The Alternative Disputes Resolution Regulations (2015) and undertakes to co–operate and comply with the recommendations made by Health Improvement Scotland who can be contacted at:
Programme Manager Independent Healthcare Services Team Healthcare Improvement Scotland
Gyle Square, 1 South Gyle Crescent
Edinburgh, EH12 9EB
Tel: 0131 623 4342 (10am–2pm, Monday to Friday) Email: his.ihcregulation@nhs.scot
10. Records and Privacy
SUR Wellness will maintain a complaints and patient feedback record, with records of informal feedback (Suggestions for improvement and service user feedback forms) and formal complaints. Personal information in individual complaints is kept confidential and is only made available to those who need it to deal with the complaint as per data protection laws.
• Complainants are given notice about how their personal information is likely to be used during the investigation of a complaint.
• Individual complaints files are kept in a secure filing cabinet in the Clinic premises and in a
restricted access section of the computer system’s file server.
• Patients are provided with access to their medical records [in accordance with the confidentiality policy]. Others requesting access to a patients’ medical records as part of resolving a complaint are provided with access only if the patient has provided authorisation [in accordance with the confidentiality policy].
11. Open Disclosure and Fairness
Complainants are initially provided with an explanation of what happened by SUR Wellness based on the known facts. At the conclusion of an inquiry or investigation, the complainant is provided with all established facts, the causal factors contributing to the incident and any reco mmendations to improve the service, and the reasons for these decisions.
Service users can make a formal complaint to Healthcare Improvement Scotland at anytime by following the procedure detailed at
http://www.healthcareimprovementscotland.org/our_work /inspecting_and_regulating_care/indepen dent_healthcare/ihc_complaints_procedure.aspx