The Silver Brief

When something goes wrong in healthcare, most people don’t immediately think about legal rules—they just want clear answers and honesty.

That’s exactly what the duty of candour is designed to protect.

In recent years, more patients and families have started searching for “duty of candour” as awareness grows. If you’re trying to understand what it means for you or a loved one, this guide explains everything in plain English—what it is, when it applies, and what you should expect.

Duty of candour: quick answer

The duty of candour is a legal requirement that means healthcare providers in England and Wales must be open and honest with patients when something goes wrong and causes harm (or could have caused harm). This includes:

• Telling you what happened
• Offering a genuine apology
• Explaining what will happen next

What is the duty of candour?

The duty of candour is a legal obligation requiring healthcare providers to be transparent when patient safety incidents occur.

In England, it is set out in Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Put simply: If something goes wrong in your care and causes harm—or could have—you have the right to be told. This duty applies to:

• NHS organisations
• Many private healthcare providers
• GP practices and other regulated services

When does the duty of candour apply?

The duty of candour applies when a “notifiable safety incident” occurs. This generally means the incident:

• Caused moderate or severe harm, or death
• Or had the potential to cause significant harm

Common examples include:

• A delayed diagnosis that worsens a condition
• A surgical error or unexpected complication
• Medication mistakes causing harm
• Failure to monitor or escalate symptoms

Minor issues that cause no harm may not trigger the formal duty—but healthcare providers are still expected to be open and honest wherever possible.

What should happen under the duty of candour?

If the duty of candour applies, healthcare providers must follow a clear process. Understanding this can help you recognise whether it has been handled properly.

1. Inform you promptly

You should be told as soon as reasonably possible after the incident is identified.

2. Provide a clear explanation

You should receive an explanation of:

• What happened
• What is known at the time
• How it may affect your health

3. Offer an apology

A sincere apology must be given. Importantly, in UK law, an apology is not an admission of legal liability.

4. Follow up in writing

You should receive written confirmation summarising:

• The incident
• The discussion
• Any next steps

5. Keep you updated

If further investigations are needed, you should be kept informed of progress and outcomes.

Why the duty of candour matters

When something goes wrong, poor communication can make an already difficult situation much worse. The duty of candour exists to ensure patients are treated with respect and honesty by promoting:

• Transparency and trust
• Early explanations
• Opportunities to ask questions
• Learning and improvement in healthcare

While openness cannot undo harm, it can make a meaningful difference in how patients and families experience what happens next.

Does the duty of candour mean negligence?

No—and this is an important distinction. The duty of candour is about honesty and communication, not blame.

• A provider can follow the duty of candour even if no negligence occurred
• A failure to be open may raise concerns, but does not automatically prove negligence

In simple terms:

• Duty of candour = being open and honest
• Medical negligence = substandard care causing harm

They are related, but legally separate issues.

What if the duty of candour is not followed?

If you feel you were not told about something that went wrong—or communication was delayed or unclear—you are not powerless. You can:

• Raise concerns directly with the healthcare provider
• Use the NHS complaints process
• Request your medical records
• Seek independent advice

A failure to follow the duty of candour can be taken seriously by regulators and may form part of a wider investigation.

How to raise concerns or get support

If you’re unsure about your situation, there are several organisations that can help you understand your rights and next steps:

• Patient Advice and Liaison Service (PALS): Provides confidential support within NHS services and can help resolve concerns informally.
• NHS complaints advocacy services: Offer free, independent help with making and presenting complaints.
• Healthwatch: Shares patient experiences and provides guidance on local healthcare services.
• Citizens Advice: Offers practical, independent advice on healthcare rights and complaints.
• General Medical Council (GMC): Regulates doctors and can investigate concerns about professional conduct.

Frequently asked questions

You might also find this helpful: No Win No Fee Medical Negligence Claims: Costs, Risks & Funding

Duty of candour: Concluding thoughts

The duty of candour represents a shift towards greater openness in healthcare. If something goes wrong, you have the right to:

• Clear explanations
• Honest communication
• A meaningful apology

Understanding these rights puts you in a stronger position to ask questions, challenge uncertainty, and ensure your care is handled with the transparency you deserve.

This guide is based on general principles of English and Welsh law, is intended for informational purposes only, and does not constitute legal advice or establish a professional relationship.