Openness and honesty when things go wrong: The professional duty of candour

About our Candour guidance

1

When we refer to ‘patients’ in this guidance, we also mean people who are in your care.

2

All health and care professionals have a duty of candour – a professional responsibility to be honest with patients when things go wrong. This is described in The professional duty of candour, which introduces this guidance.

3

As a doctor, nurse, midwife or nursing associate, you must be open and honest with patients, colleagues and your employers.

4

This guidance gives more information about how to follow the principles set out in Good medical practice2and The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates.3  Appendix 1 sets out relevant extracts from General Medical Council (GMC) and Nursing and Midwifery Council (NMC) standards and guidance. The GMC’s guidance applies to all doctors registered with it; the NMC’s standards and guidance apply to all nurses, midwives and nursing associates registered with it.

2

General Medical Council (2024) Good medical practice (accessed 31 January 2024), paragraphs 76 and 45. The GMC’s professional standards describe good practice, and not every departure from them will be considered serious. You must use your professional judgement to apply the standards to your day-to-day practice. If you do this, act in good faith and in the interests of patients, you will be able to explain and justify your decisions and actions. We say more about professional judgement, and how the professional standards relate to the GMC’s fitness to practise processes, appraisal and revalidation, at the beginning of Good medical practice

3

Nursing and Midwifery Council (2018) The Code: Professional standards of practice and behaviour for nurses, midwives and nursing associates (accessed 17 January 2022), section 14

5

This guidance is divided into two parts: 

  1. Your duty to be open and honest with patients in your care, or those close to them, if something goes wrong. This includes advice on apologising (paragraphs 7-22). 
  2. Your duty to be open and honest with your organisation, and to encourage a learning culture by reporting adverse incidents that lead to harm, as well as near misses (paragraphs 23 - 29).
6

This guidance is for individuals. We recognise that care is normally provided by multidisciplinary teams, and we don’t expect every team member to take responsibility for reporting adverse incidents and speaking to patients if things go wrong. However, we do expect you to make sure that someone in the team has taken on responsibility for each of these tasks, and we expect you to support them as needed.