Accountability, and what it means to bereaved families and harmed patients (by Corinne Cope)

Summary

In December 2022 Dylan Cope, a 9-year-old boy, died of sepsis after being discharged from hospital. A coroner found the boy's death “would have been avoided if he had not been erroneously discharged”, and said what happened "amounts to a gross failure of basic care”.

In this blog, Dylan’s mum Corinne Cope draws on her lived experience to explain what accountability means to bereaved families and harmed patients. 

Content

For me, as a bereaved mother, accountability isn’t a theoretical concept - it’s deeply personal.

And for harmed patient’s/bereaved families, it’s not what is said - it’s what changes, and whether anyone can see it.

I think many people are working incredibly hard within investigations. But from a family perspective, the outcomes don’t always reflect that effort, particularly when learning isn’t visible, or when the process feels defensive or incomplete

And we need to be clear about what accountability is, and what it isn’t.  

To any reasonable person, accountability isn’t blame or punishment.

Ownership, explanation and demonstrable change

What accountability means to harmed patient’s/bereaved families

When harmed patients and bereaved families talk about accountability, we are not asking for the impossible. We’re asking for:

• a full, honest explanation of what happened and why 
• clear ownership of actions, omissions, and decisions - and their consequences
• genuine reflection and sincere, timely apologies for both individual and organisational failures
• organisational responsibility for system failures, with prompt correction 
• and visible evidence that meaningful, timely learning and reflection has taken place 

And that final point matters most. Because accountability is not what is said - it’s the change that matters. 

Where the system is failing

From a family perspective, accountability often feels delayed, filtered, or out of view. Learning is described…but not always demonstrated.

Apologies are offered…but often without ownership.

And too often, the harmed/bereaved find themselves driving the process.

In my own experience, after Dylan’s death, I didn’t just seek answers; I found myself proposing a sepsis awareness campaign. I also found myself working to improve how investigations are carried out; encouraging organisations to respond differently to preventable harm or death, and to say: 

“We do not always get things right, we are truly heartbroken that this tragedy happened under our watch; and here is what we are doing to improve.” 

Something practical. Something needed.

But that learning wasn’t led by the organisation…much of it was driven by me.

And that is a huge part of the problem from my perspective. 

Harmed patients and bereaved families should not have to investigate, push, or drive safety improvements in response to harm or death. 

When they do, it doesn’t feel like accountability, it can feel like a continuation of the harm.

And when similar failures happen again, with little visible change, that becomes very difficult to reconcile.

Apology and honesty

I also want to say something about apology, followed by a lived example.

A sincere, timely apology is not a legal risk - it is a professional and human responsibility.

Too often, what families receive is not an apology for what went wrong, but a general expression of sympathy…“I’m sorry for your loss.”

Condolences are not the same as acknowledging failures in care.

While well-intentioned, they do not meet the expectations of candour, and for many families, they fail to acknowledge responsibility or the reality of what went wrong. 

Individual errors can and do occur alongside wider system failures and both must be explored with equal rigour, because understanding one without the other limits learning and risks repeating the same harm.

A just culture doesn’t exclude holding individuals to account where there is evidence of serious or gross negligence.

From a harmed/bereaved perspective, there is a concern that in practice, ‘no blame’ can sometimes become ‘no accountability’.

Honesty and reflection matter very deeply.

But in my experience, those elements can sometimes be delayed or filtered out. And I wonder whether apology is sometimes still viewed through the lens of blame rather than responsibility.

And that raises an important question…

Is the system, at times, protecting itself at the expense of truth and learning?

Humanity filtered

I want to give a brief example.

There was suboptimal treatment identified in Dylan’s hospital readmission. A healthcare professional involved in Dylan’s care wrote in an early statement draft that they “wished” they had stayed with him. I only saw that years later.

That single sentence - an honest expression of reflection - meant a great deal.

But it was removed from the final version.

In my experience, the very things that support accountability - reflection, honesty, humanity - were either delayed or filtered.

And when investigations feel defensive, opaque, or incomplete, the impact is not neutral…it causes secondary harm.

It erodes trust.

And it drives families to seek answers elsewhere.

Final thoughts

Accountability requires action.

Because learning without visible ownership…can feel hollow. 

And accountability without learning achieves very little.

And crucially: families should not have to drive that change themselves.

If nothing visibly changes, and families are left to fight for answers or without a timely and sincere apology, then from a family perspective, it isn’t accountability. It’s just process, that is deeply insulting and guaranteed to compound harm.

Related content

• Investigating harm with humanity - practical guidance for NHS investigators, clinical teams and legal representatives (by Corinne Cope)
• Destructive investigations: our experience of the investigation into our son's death
• Seeking better sepsis awareness in Wales (a film by Corinne and Laurence Cope)
• Dylan's Story (Welsh Ambulance Services University NHS Trust)