Duty of Candour
The Duty of Candour is the responsibility of healthcare professionals and organisations to be open, honest, and transparent with patients when providing care, particularly when something goes wrong.
There are two types of Duty of Candour: statutory and professional. While they are regulated differently, both share the same fundamental principle: patients and those receiving care have the right to be told openly and honestly when something has gone wrong, to receive an explanation, and to be offered an appropriate apology.
Statutory Duty of Candour
The Statutory Duty of Candour is a legal requirement for healthcare organisations and is regulated by the Care Quality Commission (CQC) in England.
It applies when a notifiable safety incident has occurred that has resulted in, or could result in, moderate or severe harm, prolonged psychological harm, or death.
Organisations must:
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Inform the patient (or their representative) as soon as reasonably practicable.
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Provide a truthful explanation of what is known about the incident.
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Offer a sincere apology.
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Explain what investigations will take place and what actions will be taken to prevent a recurrence.
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Keep a written record of the discussions and follow-up.
An apology under the Statutory Duty of Candour is not an admission of fault or legal liability. It is an acknowledgement that the patient has experienced an unexpected event and an expression of regret that it occurred.
The Statutory Duty of Candour became law for NHS trusts in 2014 and was extended to all other CQC-regulated providers in 2015. It was introduced following recommendations from the Francis Inquiry into failings at Mid Staffordshire NHS Foundation Trust, alongside growing recognition of the need for greater openness in healthcare after cases such as that of Robbie Powell.
The Professional Duty of Candour applies to individual registered healthcare professionals. It is set out in the standards of the relevant professional regulators, including:
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General Medical Council (GMC)
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General Dental Council (GDC)
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Nursing and Midwifery Council (NMC)
Under the Professional Duty of Candour, healthcare professionals are expected to:
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Be open and honest with patients when something goes wrong.
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Apologise promptly.
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Explain what has happened, as far as is known.
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Offer an appropriate remedy or support where possible.
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Report incidents through the appropriate organisational processes.
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Reflect on events and learn from them to improve future practice.
Unlike the statutory duty, which places legal responsibilities on organisations, the Professional Duty of Candour relates to the ethical and professional responsibilities of individual clinicians.
Together, these duties promote a culture of openness, learning, and continuous improvement, helping to maintain patient trust and improve the safety and quality of care.