What is The Duty of Candour?
5 March 2025
In its most basic sense the duty of candour is a general duty to be open and transparent. Within the medical context there are two types of duty of candour; statutory and professional. It applies to health professionals.
The duty came in 2014 as a result of failings in clinical care and awareness that when care was going wrong or there was an issue that patients were not routinely told of this, particularly if the issue resulted in an injury. There was a culture (not always) of silence or ignoring issues in many situations.
Both duties have similar aims which are to ensure those providing care are open and transparent with the service user. The General Medical Council states the professional duty as:
“Every health and care professional must be open and honest with patients and people in their care when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress. This means that health and care professionals must:
- tell the person (or, where appropriate, their advocate, carer or family) when something has gone wrong
- apologise to the person (or, where appropriate, their advocate, carer or family)
- offer an appropriate remedy or support to put matters right (if possible)
- explain fully to the person (or, where appropriate, their advocate, carer or family) the short and long term effects of what has happened.”
It also states that health and care professionals must also be open and honest with their colleagues, employers and relevant organisations, and take part in reviews and investigations when requested. They must also be open and honest with their regulators, raising concerns where appropriate. They must support and encourage each other to be open and honestand not stop someone from raising concerns.
Thus, as a patient if something has gone wrong you would expect to be told of this even if it hasn’t resulted in injury. You should expect to receive an apology (verbally and/or in writing), an explanation of what happened, what can be done or what may happen and what can be done to prevent it happening to someone else. The guidance is clear that an apology is not the same as an admission of legal liability.
Is this happening in practice?
Our experience is that it is sometimes happening in practice but often only if a patient complains about their care or treatment. On occasions there is an open apology and explanation of what has happened before a patient is aware something may have happened. Sometimes this duty of candour can be in response to formal complaints in writing. In England this can be in complaints responses and in Wales in “Putting it Right” responses. In Wales they state “if the care or treatment we provide has caused moderate harm, severe harm or death, we will follow the Duty of Candour”.
What we often see are explanations that may answer some of the patients concerns but often the responses are at odds with what the experts we may instruct will opine. That is often the case in legal cases and so not necessarily unexpected however often the letters from the Trusts or Health Boards can be somewhat dismissive and not fully answering concerns. Unless the patient is tenacious many would not pursue further or obtain the answers and indeed compensation they may be entitled to.
The Duty of Candour is most definitely a step in the right direction but in our experience needs to be used better, more openly and fully.
This article was written by Redkite Solicitors, Madeleine Pinschof. To find out more about Madeleine and the support that she can provide to you, visit her website profile here: https://www.redkitesolicitors.co.uk/team/madeleine-pinschof/
The contents of this article are intended for general information purposes only and shall not be deemed to be, or constitute legal advice. We cannot accept responsibility for any loss as a result of acts or omissions taken in respect of this article.