What is Duty of Candour?

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Georgina Emsley

Solicitor, Medical Negligence

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Healthcare professionals have a responsibility called the Duty of Candour. This means they must be honest when something goes wrong. Here's what they need to do:

  • Tell the person (or their advocate, carer, or family) when something went wrong.
  • Apologize to the person (or their advocate, carer, or family)
  • Offer appropriate help or support to fix the problem if possible.
  • Explain fully to the person (or their advocate, carer, or family) what happened and its effects.

They must also be honest with colleagues, employers, and relevant organizations, participating in reviews and investigations when asked. They should support and encourage each other to be honest and not prevent anyone in the industry from raising concerns.

If medical negligence occurs, a healthcare provider should offer reasonable support and solicitors will also seek an apology. Failing to fulfil the Duty of Candour can lead to an offence for which the Care Quality Commission (CQC) may prosecute them.

The Care Quality Commission (CQC) is the independent regulator of health and adult social care in England. They ensure health and social care services are provided to people with safety, are effective, compassionate and of high-quality. 

Additionally, they monitor, inspect and regulate services and publish what they find. Where they find evidence of poor care, they have powers authorising them to take appropriate action. The CQC are able to take action including: 

  • Using requirement notices or warning notices to set out what improvements the care provider must make and by when
  • Making changes to a care provider's registration to limit what they may do, for example by imposing conditions for a given time
  • Placing a provider in special measures, where they closely supervise the quality of care while working with other organisations to help them improve within set timescales
  • Hold the care provider to account for their failings by issuing simple cautions, issuing fines and prosecuting cases where people are harmed or placed in danger of harm

The reason that the CQC are able to take action of this nature is because they use such powers in order to: 

  • Protect you from harm and make sure you receive care that meets the standards you have a right to expect
  • Make sure services improve if the standard of care they provide has fallen below acceptable levels
  • Hold care providers and managers to account for failures in how care is provided

They refer to the Duty of Candour as being a general duty to be open and transparent to those receiving your care. It applies to every healthcare and social care provider that is regulated by the CQC.

The Duty of Candour requires registered providers and registered managers (known as ‘registered persons’) to act in an open and transparent way with people receiving care and/or treatment from them. The regulation also defines ‘notifiable safety incidents’ and specifies how registered persons must apply the Duty Of Candour if any of these incidents occur.

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NHS Trust Fined in First Ever Lack of Candour Prosecution

University Hospitals Plymouth NHS Trust was recently fined by the CQC for failing to discharge its Duty of Candour, following the death of a patient at Derriford Hospital.

The CQC brought the prosecution after it discovered the NHS Trust had failed to share information with a patient’s family as to what had happened, or apologised within a timely manner. The NHS Trust admitted to its failings and was ordered to pay a fine plus legal costs totalling more than £12,000.00.

Following the judgment, Deputy Judge Joanna Matson described it as “a very good example of why these regulatory offences are very important.” She went on to say “Not only have (the family) had to come to terms with their tragic death, but their loss has been compounded by the Trust’s lack of candour,”

What Should Happen?

The Care Quality Commission states that healthcare providers must “promote a culture that encourages, candour, openness and honesty at all levels” as well as commit to being “open and transparent at board level or its equivalent, such as a governing body”.

This means that if medical negligence does take place, the healthcare provider responsible must assess whether it should tell the patient what’s happened.

In order to meet the regulations, they must:

  • Tell the relevant person, in person, as soon as is reasonably practicable after a safety incident has occurred
  • Provide support to them in relation to the incident
  • Give an accurate account of what’s happened
  • Advise the patient what further enquiries they believe are appropriate
  • Offer an apology
  • Follow up the apology by giving the same information in writing, and providing an update on the enquiries
  • Keep a written record of all communication with the relevant person

It’s crucial to note that receiving an apology from the healthcare provider, hospital or care provider is not actually an admission of fault. In fact, NHS Resolution encourages an apology to be made as it is: 

  • always the right thing to do
  • not an admission of liability
  • acknowledges that something could have gone better
  • the first step to learning from what happened and preventing it recurring

NHS Resolution is a body of the Department of Health and Social Care. They provide expertise to the NHS on resolving concerns and disputes fairly, sharing learning for improvement and preserving resources for patient care.

The Duty of Candour was created because of concerns about the behaviour and lack of transparency in some NHS Trusts. It’s aim was to build trust between healthcare professionals and patients, who have suffered harm. As such, the fact that an NHS Trust has recently been prosecuted for not discharging this duty is a stark reminder to healthcare professionals that they must remain open and transparent.

These are fundamental principles to our Medical Negligence Solicitors, who are always keen to work with the NHS to settle compensation claims. We make sure to encourage dialogue and positive engagement. Every time we settle a claim we really want to achieve two things (1) the best possible settlement for our client and (2) for the NHS to learn lessons for the future, so that the same mistakes aren’t made again.

We have found by using methods such as mediation, both parties are afforded the opportunity to speak to each other in a non-confrontational setting and come away properly understanding each perspective.

The fact that a prosecution has been made by the CQC in respect of the Duty of Candour will hopefully encourage NHS Trusts to act with openness and an attitude to settle claims amicably.

Does Duty of Candour Apply to Armed Forces Medics?

If you are serving in the British Armed Forces or are a veteran and you received medical treatment by medics in the armed forces, then it’s important to know that Duty of Candour also applies to you.

If you think you have received negligent medical treatment, you may have a claim for compensation. The process for making a compensation claim works in the same way as it would had been treated under the NHS and our expert team of Medical Negligence Solicitors are able to assist you with this.

How Can Simpson Millar Help?

The aim of compensation is to compensate a person for their loss and to put them back in the position that they would have been in, had the incident/ negligence not occurred.

If you have been affected by medical negligence and wish to pursue a claim for compensation, you can contact our friendly and helpful team today on 0808 239 6043. Alternatively, you can request a call back. We may be able to take on your case on a No Win, No Fee basis – just ask us about this and the different funding options available to you.


Care Quality Commission. (n.d.). Regulation 20: Duty of Candour. Retrieved from https://www.cqc.org.uk/guidance-providers/all-services/regulation-20-duty-candour. (Accessed: 31/12/2023)

Care Quality Commission. (n.d.). Home. Retrieved from https://www.cqc.org.uk/ (Accessed: 31/12/2023)

Care Quality Commission. (n.d.). About Us. Retrieved from https://www.cqc.org.uk/about-us (Accessed: 31/12/2023)

Care Quality Commission. (n.d.). How We Do Our Job: Taking Action. Retrieved from https://www.cqc.org.uk/about-us/how-we-do-our-job/taking-action (Accessed: 31/12/2023)

Care Quality Commission. (n.d.). Our Purpose & Role: Who We Are. Retrieved from https://www.cqc.org.uk/about-us/our-purpose-role/who-we-are (Accessed: 31/12/2023)

General Medical Council. (n.d.). Being Open and Honest with Patients in Your Care and Those Close to Them When Things Go Wrong. Retrieved from https://www.gmc-uk.org/professional-standards/professional-standards-for-doctors/candour---openness-and-honesty-when-things-go-wrong/being-open-and-honest-with-patients-in-your-care-and-those-close-to-them-when-things-go-wrong (Accessed: 31/12/2023)

NHS Resolution. (n.d.). About. Retrieved from https://resolution.nhs.uk/about/ (Accessed: 31/12/2023)

The Guardian. (2020, September 23). NHS trust fined for lack of candour in first prosecution of its kind. Retrieved from https://www.theguardian.com/society/2020/sep/23/nhs-trust-fined-lack-of-candour-first-prosecution-of-its-kind-plymouth (Accessed: 31/12/2023)

Georgina Emsley

Solicitor, Medical Negligence

Areas of Expertise:
Medical Negligence

Georgina is a Solicitor who works in our Medical Negligence team here at Simpson Millar, based in our Manchester office.

She is a committed and highly reliable Solicitor with a track record of supporting clients through the process of making a claim to achieve the best outcome for them. Georgina has experience working on many high-value cases with a range of circumstances and complexities from start to finish, where she reviews medical records, liaises with experts and gathers evidence in order to negotiate the best possible settlement for her clients.

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