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CQC - Learning, candour and accountability report

This report describes what CQC found when it reviewed how NHS trusts identify, investigate and learn from the deaths of people under their care. It concludes that many carers and families do not experience the NHS as being open and transparent and that opportunities are missed to learn across the system from deaths that may have been prevented. Many of the NHS staff we heard from shared this view, together with a commitment for this to change. They found that the level of acceptance and sense of inevitability when people with a learning disability or mental illness die early is too common. This may often be due to unidentified or unsupported health needs that, in many cases, will offer even greater opportunity for learning.   The full report can be found at:

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