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Being open with patients about medical error: challenges in practice

There is a significant body of evidence showing that patients want to know when they are harmed as a result of their medical care. In 2005 the National Patient Safety Agency issued guidance on the process to be followed when communicating errors to patients and their carers. However, there is still a significant gap between the rhetoric of being open and clinical practice. This gap reflects the competing interests arising from the concept of being open and the difficulties involved in the process itself. This paper presents several case studies to explore the complexities of being open and the organizational support required to overcome these.