LAWYERS have warned ministers to take care over moves to ensure medical and social care staff are upfront about all medical blunders.

While the Scottish Government proposes a statutory duty of candour, the Association of Personal Injury Lawyers (APIL)warned against the possibility that disclosable events would unnecessarily include near misses which would be "too burdensome" for healthcare workers and worrying to the patient.

The duty of candour move, if approved, means health and social care services staff will be legally obliged to tell families when a patient has been accidentally harmed.

The government revealed the plans in October, and form part of a UK-wide effort to end cover-ups of abuse and neglect of NHS patients highlighted after the inquiry into the deaths of up to 1,200 patients at two Mid Staffordshire hospitals.

A consultation has been launched on the proposals designed to improve transparency and drive up standards.

For more than 50 years, the Medical Defence Union has advised doctors to tell patients when things go wrong, apologise and try to put things right. The duty of candour turns this into not just an ethical duty, but a statutory duty.

The Scottish Government proposes that there should eventually be drawn up a threshold to which events need to be disclosed.

Gordon Dalyell, Scottish representative of APIL said: "Telling patients about every slight incident, even if there was no harm, may cause patients to lose confidence in hospital and care staff. But while the duty should not be overbearing, near misses should still be taken seriously. We need balance."

APIL says disclosure should relate to incidents that cause some harm as indicated in the consultation document.

"This strikes the balance between providing the patient with an apology if something has happened to them, without requiring the doctors to divulge every 'near miss'," said APIL.

"This is not to say that near misses and slight incidents should not be taken seriously and addressed to ensure that they do not occur again, but this is a separate issue to the duty of candour.

"The purpose of the new statutory duty is to increase openness between the service provider and user. This can be achieved without the need to cause unnecessary worry to the patient; and without overloading health and social care professionals with an unmanageable administrative burden.

"If the duty is not overbearing, health and social care professionals are likely to embrace a new culture of openness. This would hopefully lead to more openness and transparency as a whole, and not just in the situations specified in the consultation."

APIL also believes the obligation of candour should apply to the individual, and not on the organisation or employer.

"We believe that an individual duty would be simpler and much less bureaucratic, thus increasing the likelihood that the duty will be complied with," they said in a memo to ministers.

"Arguably, there is already an organisational duty of candour when the NHS complaints procedure is followed correctly. The reality, though, is that this is often ignored. Sometimes this is because the Complaints Officer is not provided with a candid explanation from the medical professional that he/she can convey in the complaints response.

"An individual duty on the professional would hopefully improve the existing processes and allow the patient to receive a more satisfying explanation of what went wrong"

The government's proposals state: "Disclosable events would be defined as (an) unintended or unexpected event that occurred or was suspected to have occurred that resulted in death, injury or prolonged physical or psychological harm being experienced by a user of health and/or social care services."

The duty of candour move falls short of Francis's recommendation to make non-disclosure of harm caused a criminal offence for NHS doctors, nurses or managers. But the Scottish Government believes it will make it easier for staff to speak out.