The National Health Service will be forced to admit any safety failures and mistakes under strict new rules that will be embedded within contracts next year.

From April 2013, all commissioning contracts will include a contractual duty of openness, meaning that all NHS organisations will be required to tell patients if their safety has been compromised and ensure that lessons are learnt from any mistakes.

In the current status quo it is expected of the NHS to be open about any errors, although there is no contractual duty to do so, which means organisations are not held to account for keeping any failures under wraps.

The finer details of the new contractual arrangements are yet to be decided by the NHS Commissioning Board, but it is expected that the chiefs of any NHS organisations found not being open with patients will be made to apologise in writing to the patient and report the breach to the Care Quality Commission. 

It is also likely that strict action plans to prevent the breach happening again will be required, "with repeated contractual breaches leading to more stringent action," the Department of Health said.

Robert Francis is expected to make further recommendations on the "duty of candour" in his report on the Mid Staffordshire Inquiry, following appalling standards of care - even leading to patient deaths - at the hospital.

"But we cannot wait - creating this contractual duty of candour now ensures that NHS contracts for the next financial year will champion patients’ rights to basic honesty, as well as safe care,” said health minister Dan Poulter.

Call for a statutory duty

However, Peter Walsh, chief executive of charity Action against Medical Accidents described the move as "an apparently cynical attempt to sidestep overwhelming support for a statutory duty and to pre-empt the public inquiry report". 

He said the charity and other patients groups will continue to press for a full statutory duty of candour as part of the 'Essential Standards of Quality & Safety' regulated by the Care Quality Commission.