The professional duty of candour, explained

Being honest when something goes wrong sounds like a matter of personal decency rather than a formal requirement. In UK health and social care it is both. There is a professional duty of candour that applies to you as an individual registrant, and a statutory duty that applies to organisations. Understanding how the two fit together, and what each actually requires, matters because candour is one of the areas where good people get into difficulty by handling a situation badly rather than by causing harm in the first place.

The two duties

**The professional duty** applies to you personally through your regulator's standards. The regulators for doctors and for nurses, midwives and nursing associates published joint guidance on candour, and the same expectations run through the standards set by other health and care regulators. In essence it requires you to be open and honest with patients or service users when something goes wrong with their care, to apologise, to put things right where possible, and to explain the likely effects. It also requires you to be open and honest with your employer and colleagues, and to take part in reviews and investigations honestly.

**The statutory duty** applies to registered providers rather than to individuals, and sits in regulations enforced by the care regulator. It sets out what an organisation must do when a notifiable safety incident occurs: notify the person affected, do so in person where practicable, give a truthful account of what is known at the time, offer an apology, explain what further enquiries will be made, and follow up in writing with a record kept.

Both duties therefore point the same way. The professional duty shapes what you do at the bedside; the statutory duty shapes what the organisation does formally.

What triggers it

The professional duty engages whenever something goes wrong with care and the person has suffered harm or distress, or could do in future. The threshold is deliberately low. It is not limited to serious incidents, and it is not limited to cases where someone is obviously injured.

The statutory duty is narrower and defined by thresholds around notifiable safety incidents, with different definitions applying to different types of provider. Whether a particular event crosses the statutory threshold is usually a decision for the organisation's governance process rather than for you at the point of care.

The practical consequence is that you should not wait to find out whether something is formally notifiable before being honest with the person in front of you. Those are different questions on different timescales.

What "being open" actually looks like

The parts people find difficult are rarely the principles. They are the specifics.

**Say something promptly.** As soon as it is reasonably practicable, and before the person hears it from someone else or works it out for themselves. Delay is what turns a manageable conversation into a complaint.

**Say what is known, and say what is not yet known.** You are not required to have the full explanation before you speak, and you should not speculate about cause. "This has happened, we do not yet know why, and here is what we are doing to find out" is a complete and honest position.

**Apologise properly.** An apology is an expression of sorrow or regret. It is not an admission of legal liability, and both regulators and the NHS Resolution guidance have been explicit that saying sorry is expected rather than risky. "I am sorry this happened to you" is appropriate and is not the same as accepting blame on behalf of an organisation.

**Avoid the passive voice.** "Mistakes were made" and "the medication was given late" are the phrasings that make people feel handled. Plain language about what happened is better received, even when it is harder to say.

**Explain what happens next.** What will be reviewed, by whom, roughly when, and how they will be told the outcome. Then make sure it actually happens, because failing to follow up is a frequent cause of complaints escalating.

**Record it.** What you said, when, to whom, and what was agreed. This protects everyone, including you.

Candour toward your employer and colleagues

The duty is not only outward-facing. You are expected to report incidents and near misses through your organisation's systems, to be honest in investigations, and to raise concerns about risks to safety even when they do not involve your own actions.

This is the part where people sometimes hesitate, particularly when reporting could reflect badly on a colleague or on their own practice. Regulators have been consistent that failing to be candid is itself a serious matter, and in practice the professional consequences of concealment are routinely worse than the consequences of the original error.

Where it interacts with other things

**It is separate from the complaints process.** Being candid does not depend on someone complaining, and it does not replace a formal complaint response if one is made.

**It is separate from disciplinary action.** Reporting an incident is not the same as admitting a disciplinary offence, and most incidents are handled as learning rather than misconduct. Organisations are increasingly expected to work within a patient safety approach that focuses on systems rather than individual blame, though this varies in practice.

**It does not override confidentiality in the other direction.** Candour is owed to the person affected and, where appropriate, to those close to them, subject to the usual rules about consent and capacity.

**It is not a substitute for legal advice.** Where an incident is serious, or where you may be personally criticised, tell your union or defence organisation early. Being candid and taking advice are not in conflict; the advice is about how to engage properly, not whether to.

If you get it wrong

People sometimes realise afterwards that they should have said something sooner, or that what they said was incomplete. The right response is to correct it, promptly and openly, rather than to hope it settles. Late candour is far better received than none, and regulators have consistently treated attempts to conceal or minimise as substantially more serious than the underlying error.

The short version

Tell the person, tell them soon, tell them what you know and what you do not, apologise sincerely, explain what happens next, follow through, and write it down. Report it internally through the proper route and be straight in any review. Take advice early if the matter is serious.

None of this makes a difficult conversation easy. It does, reliably, make the aftermath less damaging for the person harmed and for you.

For the detailed requirements, your regulator's guidance on candour and the care regulator's guidance on the statutory duty are the authoritative sources, and your employer's incident reporting policy sets out the local process.

This guide is general information, not legal, immigration or medical advice. Always confirm current requirements with the relevant official body.