Organisational Duty of Candour: non-statutory guidance - revised March 2025

6. Support and Training for Staff

Organisations must ensure that all staff who carry out the organisational duty of candour procedure on their behalf receive relevant training, guidance and support on the procedure.

Incidents can be extremely distressing for staff involved, not just patients and their loved ones. Organisations must provide details of services or support of which they are aware to any employees who were involved in the incident, are activating the organisational duty of candour procedure or undertaking the review. The details of services or support should be accessible, and organisations should ensure staff have sufficient support and time to engage with them.

Resources that may help staff include, for example:

• Breathing Space | NHS 24^[15]
• National Wellbeing Hub^[16]
• Workforce Wellbeing; Beyond the pandemic and into the future^[17]
• Frontline Workers > Self-leadership^[18]
• Trauma – national trauma transformation programme | NHS Education for Scotland^[19]
• Local Human Resources
• Local Team Support Services (For example: SALUS in NHS Lanarkshire^[20])

Healthcare Improvement Scotland (HIS) and NHS Education for Scotland (NES) have worked together to develop training materials for review, learning and improvement at individual, team, organisational and national level in a complex healthcare system (this work is known as the ‘Joint Commission’). This Joint Commission seeks to take a human factors and safety science approach to minimising duplication and reducing variation in review processes as well as supporting and upskilling staff in leading and taking part in these. A person-centred learning zone is available for all organisations and can be found on Turas: Joint commission safety openness and learning | Turas | Learn (nhs.scot)^[21]

An e-learning resource has been produced by NES, the Scottish Social Services Council, the Care Inspectorate and Healthcare Improvement Scotland. Relevant staff should be encouraged to complete the module. It is available here: Duty of candour | Turas | Learn (nhs.scot)^[22]

Staff involved in various stages of the incident, or organisational duty of candour procedure, may need different support to each other. The suggested resources should take account of the circumstances relating to the incident as well as the employee’s needs. Organisations could offer support within the organisation (such as opportunities to speak to HR, someone from a staff wellbeing service or Employee Assistance Programme) or signpost to services external to the organisation.

Organisations should ensure immediate access to support for staff involved in an incident. This aims to lessen the impact of trauma on the staff member and to help with their health, wellbeing and recovery.

Immediately following an incident is a vital time to help any staff involved to understand what happened. It is important that they do not feel isolated and that the potential impact on them is acknowledged. Assessing the needs of staff members helps the organisation to fulfil its duty of care to them by identifying need and then offering support. It is important that staff involved in an incident can access psychological first aid and have access to appropriate debriefing and support (including peer support) at any stage of the review process.

Providing support for staff can reduce sickness absence following an incident. This benefits not only the staff member, but also their colleagues who might otherwise have had to work additional hours to provide care, placing strain on them.

Things to consider:

Which staff are likely to require knowledge of the organisational duty of candour procedure?

• do staff who are meeting with the relevant person feel knowledgeable and confident in determining the impact of the incident on wellbeing?
• do your staff have sufficient advice and support available to them, for their wellbeing, when they are part of organisational duty of candour procedures?
• are staff aware of, and able to access, internal points of contact for support or external support services to help them in relation to being involved in the unexpected or unintended incident?
• have staff been provided with access to compassionate communication training?