Duty of Candour in Healthcare Practice
CPD-AccreditedCertified byThe CPD Certification Service, UK
Remediation · All UK healthcare regulators CPD Certified
Duty of Candour in Healthcare Practice
Facing a complaint or allegation about a failure of candour? Start here.
A CPD-certified remediation course for Doctors, Dentists, Nurses, Midwives, Pharmacists
and all other Healthcare Professionals responding to a concern
raised with the GMC, GDC, NMC, GPhC, HCPC, GOC, GCC, GOsC or Social Work England. Written
for allegations about not telling a patient something had gone wrong, telling them late or telling
them only part of it, an apology that was not one, and assuming someone else had done it.
Bulk buy — any 10 courses
Instant access · certificate on completion · CPD certified
Who this course is for
For healthcare professionals answering a concern about openness — and for anyone who has
to have the conversation and wants to get it right. The professional duty is common to every regulator, so
unlike most of our courses this one is not written to a single standard.
A concern has been raised about openness
The allegation is that you did not tell someone, or told them late, or told them less than the whole of it. This is the course that speaks directly to that.
Something has just gone wrong
You need to have the conversation and you are not sure what to say, how much to say, or how soon. Start here — timing is one of the few things still in your control.
You are under fitness to practice investigation
A case is open with the GMC, GDC, NMC, GPhC, HCPC, GOC, GCC, GOsC or Social Work England and you need documented CPD and written reflection to put behind your response.
The incident was never reported internally
The conversation with the patient may have happened, but the incident went unreported, or a colleague was left to raise it. That is the same duty, and it is examined separately.
You lead or supervise a team
Section 5 is about culture: why people stay quiet, and what a team looks like where they do not.
The concerns this course speaks to
Candour allegations have a recognisable shape, and almost none of them start as a decision to
conceal.
Delay
The conversation happened, but weeks later, or only once the complaint arrived. How to account for a delay honestly rather than explaining it away.
Partial disclosure
Something was said, but not the whole of it — and the rest emerged later from the records or from someone else.
The apology that was not one
“I’m sorry you feel that way”, defensive framing, or an explanation offered in place of regret.
Assuming someone else did it
In a team, everyone can believe the conversation was had by somebody else. The duty is on you to make sure it happened.
Near misses
Where nothing reached the patient. What the professional duty asks of you, and where it differs from the organisational one.
Records that do not match
Notes written after the fact, or a discussion that appears nowhere. Documentation is what makes a candid conversation provable.
What the course covers
Six sections and 25 lessons, with a reflective quiz closing each of the first five sections and
a post-course assessment at the finish.
Understanding the duty of candour
Five lessons: what it is, why it matters, when it applies, candour in everyday practice rather than only after serious incidents, and its ethical foundations.
Professional guidance from regulators
The expectations shared across the healthcare professions, and what follows when the duty is breached.
Being open when things go wrong
Six lessons and the practical core: responding openly, why timeliness matters, how to structure a candid conversation, apologising without blame, reassurance without false promises, and the everyday openings most people miss.
Reflection and insight after an incident
Five lessons: why reflection matters here specifically, what makes reflection insightful rather than descriptive, questions to guide it, making it habitual, and how it feeds remediation.
Team culture and leadership
Six lessons: candour as a team responsibility, the barriers that keep people quiet, what a candour-supportive culture looks like, leading by modelling it, supporting colleagues through it, and embedding it.
Summary and assessment
Conclusion, followed by a post-course assessment. Your certificate is issued on completion.
How this helps if a concern has been raised
Failures of candour are judged more harshly than the original error
This is the pattern that runs through fitness to practice decisions across every regulator. A clinical
mistake, openly acknowledged and remediated, is usually survivable. The same mistake concealed, minimised,
or disclosed only once someone else raised it, becomes a question about your honesty
— and honesty allegations attract the most serious sanctions available.
That is why the written response matters so much. A reflection that names the clause of your own
standards actually engaged, sets out what you now understand about why you did not speak sooner, and shows
what has changed, answers the concern. One that explains why the incident happened, without
addressing the silence that followed it, answers a question nobody asked.
On completion you receive a certificate recording the course title, the CPD hours and the date —
which, with your own written reflection, is suitable for inclusion in a remediation
portfolio, an appraisal folder, a revalidation submission or a response to your regulator. For
courses written to your own regulator’s standards, see courses by regulator.
Read the guidance yourself
Candour: openness and honesty when things go wrong ↗
The 2014 joint statement from eight regulators ↗
The professional duty, in full ↗
The statutory duty across the UK nations ↗
Ready to start?
Written for professionals answering a concern about openness. Instant access, 2 CPD hours, certificate on completion.
Who wrote it
Course facilitator and author, Probity & Ethics
Dr Iqbal has designed and delivered ethics, probity and professionalism training for UK healthcare
professionals since 2020, working with registrants of all nine UK healthcare regulators, online and face
to face. He combines clinical practice with formal postgraduate training in healthcare law and
ethics.
MBBS · MRCS · MRCGP · Postgraduate Certificate in Healthcare Law and
Ethics, University of Dundee
Written and reviewed by Dr Shehzad Iqbal. Last reviewed
.
What is the duty of candour, and whose duty is it?
There are two duties and they are commonly confused. The professional duty sits on
you and comes from your regulator: be open and honest with a patient when something goes wrong
with their treatment or care that causes, or could cause, harm or distress. The statutory
duty sits on organisations and comes from legislation, which differs by nation — England
since 2014, Scotland since 2018, Wales since April 2023, and Northern Ireland still without one.
The practical consequence is the one people miss: your employer discharging its duty does not
discharge yours. If you were the professional involved, the professional duty was still yours, in
all four nations and in independent practice as much as in the NHS. That gap is exactly what a case
examiner looks for.
What these words mean
The terms a regulator will use about a candour concern, and what each one means in practice.
Professional duty of candour
The duty on you as an individual registrant to be open and honest with a patient when something goes wrong with their treatment or care that causes, or has the potential to cause, harm or distress. It comes from your regulator, so it applies in all four UK nations and in independent practice.
Statutory duty of candour
The duty on organisations, created by legislation and differing by nation. England has had one since 2014, enforced by the Care Quality Commission; Scotland since 2018; Wales since April 2023. Northern Ireland has no general statutory duty, although the Being Open Framework has applied to health and social care organisations there since 1 April 2026. None of it discharges the professional duty on the individual.
Apology
An expression of regret that something has happened. Regulators state directly that it is not an admission of legal liability or of personal fault, and an early apology is among the things most likely to prevent a concern escalating.
Near miss
An incident with the potential to reach a patient that did not. Internal reporting is expected so that a service can learn before harm occurs; whether the patient is told is a judgement to be made and recorded.
Being open
The wider expectation that openness runs through everyday practice rather than switching on after a serious incident: raising concerns, reporting incidents, and telling people what happened before they have to ask.
Openness with colleagues and regulators
The half of the duty people forget. Alongside telling the patient, you are expected to be open with colleagues, your employer and your regulator, and not to prevent anyone else from raising a concern.
Insight
Understanding what went wrong, why it happened, and the effect it had on the person on the other side of it. In a candour case it also means identifying why you did not speak sooner, rather than only why the incident occurred.
Remediation
The concrete steps taken so the same thing does not happen again — training, changes to how you escalate, record and communicate, supervision — together with evidence that they happened and have been sustained.
Two duties, and only one of them is yours
People conflate them constantly, including in written responses to regulators. They are not the
same thing and they do not sit on the same shoulders.
The statutory duty is on organisations
It applies to the provider, not to you personally, and it differs by nation: England since 2014, enforced by the Care Quality Commission; Scotland since 2018; Wales since April 2023.
Northern Ireland is the exception, for now
There is still no general statutory duty there. The Being Open Framework has applied to health and social care organisations since 1 April 2026, and legislation for an organisational duty is in progress. Your professional duty was never affected by any of it.
The professional duty is on you
It comes from your regulator rather than from legislation, so it applies in all four nations and in independent practice as much as in the NHS. It was set out in a 2014 joint statement from eight UK healthcare regulators and appears in each regulator’s own standards.
“My trust handled it” is not an answer
Nor is assuming a colleague had the conversation. In a team everyone can believe someone else did it; the duty is on you to make sure it happened.
What the professional duty requires
Four things, whenever something goes wrong with treatment or care that causes, or has the
potential to cause, harm or distress. Not three, and not “when asked”.
Tell them
The patient, or where appropriate their advocate, carer or family. Promptly, and without waiting to be asked or for an investigation to conclude.
Apologise
An expression of regret that this has happened. Regulators say directly that an apology is not an admission of legal liability, and saying sorry early is one of the few things most likely to stop a concern escalating.
Offer a remedy
An appropriate remedy or support to put matters right, where that is possible — practical as well as clinical, and offered rather than waited for.
Explain the effects
Fully, covering both the short and the long term consequences of what has happened. This is the step most often skipped, and its absence is what makes an otherwise adequate conversation look partial afterwards.
The half of the duty that is not about the patient
The joint statement asks for three further things, and they are the ones that go missing from
written responses. A good conversation with the patient does not answer any of them.
Be open with colleagues and your employer
Including relevant organisations, and taking part in reviews and investigations when you are asked to. An incident discussed with the patient but never reported internally leaves the obvious question open.
Be open with your regulator, and raise concerns
Openness runs upwards as well as outwards. Where something needs raising, raising it is part of the duty rather than an optional extra.
Support others in doing the same
Encourage colleagues to be open, and never discourage or prevent someone from raising a concern. Obstruction is treated far more seriously than the incident that prompted it.
Frequently asked questions
What is the difference between the professional and the statutory duty of candour?
The professional duty sits on you as an individual and comes from your regulator. The statutory duty sits on organisations and comes from legislation, which differs by nation: England has had one since 2014, enforced by the Care Quality Commission; Scotland since 2018; Wales since April 2023. Northern Ireland still has no general statutory duty, although the Being Open Framework has applied to health and social care organisations there since 1 April 2026 and legislation for an organisational duty is in progress. Your professional duty applies in all four nations regardless, and in independent practice as much as in the NHS.
Which professions is this remediation course for?
All UK healthcare professionals. It is written for doctors regulated by the GMC, dentists and the dental team regulated by the GDC, nurses, midwives and nursing associates regulated by the NMC, pharmacists and pharmacy technicians regulated by the GPhC, HCPC-registered professionals, optometrists and dispensing opticians regulated by the GOC, chiropractors regulated by the GCC, osteopaths regulated by the GOsC, and social workers. The professional duty of candour is common to all of them.
What exactly does the professional duty require me to do?
Four things, whenever something goes wrong with treatment or care that causes, or has the potential to cause, harm or distress. Tell the person, or where appropriate their advocate, carer or family. Apologise. Offer an appropriate remedy or support to put matters right, if that is possible. And explain fully the short and long term effects of what has happened. You must also be open with colleagues, employers and your regulator, and not stop anyone else from raising a concern.
Does apologising mean admitting liability?
No, and the regulators say so directly. An apology is an expression of regret that something has happened; it is not an admission of legal liability or of personal fault. Saying sorry early is one of the things most likely to stop a concern escalating, and failing to say it is one of the things most likely to make a complaint worse. The course has a lesson on the wording.
Which regulators does this apply to?
All of them. The professional duty was set out in a 2014 joint statement from eight UK healthcare regulators — the GCC, GDC, GMC, GOC, GOsC, GPhC, NMC and the Pharmaceutical Society of Northern Ireland — and the same expectation appears in each regulator’s own standards. The HCPC and Social Work England were not signatories to that statement, but the equivalent duty sits in their own standards: for HCPC registrants it is standard 8, be open when things go wrong.
My employer handled it. Doesn’t that discharge the duty?
No. Your employer discharging its organisational duty does not discharge yours. If you were the professional involved, the professional duty was still yours — and the gap between the two is exactly what a case examiner will look for. Nor is it enough to assume a colleague had the conversation; the duty is on you to make sure it happened.
The incident has already happened and I did not say anything at the time. Is it too late?
No, and this is one of the most common situations the course addresses. A late candid conversation is better than none, and how you account for the delay matters. A response that explains what you now understand, what you have changed, and why the delay happened will read very differently from silence — but take advice from your indemnity provider before making contact.
Does the duty apply if the mistake was minor and nobody was harmed?
It can, and this is where people misread it. The trigger is something going wrong with treatment or care that causes, or has the potential to cause, harm or distress — so distress counts, and so does potential. A small error that reached the patient and unsettled them is within the duty even though no clinical harm followed. The proportionate response to a minor matter is a short, prompt, honest conversation, not a formal process; what is not proportionate is deciding on the patient’s behalf that it was too small to mention.
What about near misses, where nothing reached the patient?
The professional duty and the organisational duty diverge here, and the course covers the difference. Broadly, reporting near misses internally is expected because it is what allows a service to learn before harm occurs; whether the patient is told is a judgement rather than an automatic requirement. Being able to explain which you did and why is the point.
What does the duty require of me towards colleagues and my regulator?
More than most people realise, and it is the half of the duty that rarely appears in a written response. Alongside telling the patient, you are expected to be open and honest with colleagues, with your employer and with your regulator when something goes wrong, to report incidents and near misses through the proper route, and not to prevent or discourage anyone else from raising a concern. A response that describes a good conversation with the patient but is silent on whether the incident was reported internally leaves an obvious question open.
What if speaking up is difficult where I work?
It is the commonest reason people give, and on its own it is treated as an explanation rather than an answer. Fear of blame, hierarchy, workload and a culture where incidents are handled quietly are all real, and section 5 of the course is about exactly that. What a regulator assesses is what you did in spite of it, and what has changed since — which is why naming the barrier honestly and then showing the step you took anyway reads as insight, where naming it alone reads as a defence.
Will completing this course resolve my fitness to practice case?
No. No course, from us or from anyone else, determines the outcome of a fitness to practice matter. What a course can do is help you build the insight and reflection your response needs, and give you a verifiable certificate to evidence it. Your indemnity provider, defence organisation or a specialist regulatory adviser should advise on your own case.
Is this course approved or endorsed by a regulator?
No. No UK healthcare regulator approves, accredits or endorses courses from any provider, including us, and none of them keeps an approved list. The course is certified by The CPD Certification Service, an independent accreditation body, under Provider No. 13197.
How long does it take, and is it CPD certified?
It runs to 2 CPD hours across six sections and 25 lessons, with a reflective quiz closing each of the first five sections and a post-course assessment at the end. The certificate is CPD certified by The CPD Certification Service and records the course title, the hours and the date, which is what makes it usable in an appraisal folder, a revalidation submission or a remediation portfolio. It is self-paced, and you can stop and resume.
Courses that work alongside this one
Honesty and integrity more widely — the category a failure of candour is usually assessed under.
How the conversation itself is conducted, with patients and families, when the news is bad.
Incident reporting, near misses and the safety culture that candour depends on.
The element assessed in almost every case, whatever the allegation, and the one most often described as lacking.
How to write reflection that reads as understanding rather than regret, in your own words.
Turning insight into concrete, evidenced change that a panel can see actually happened.
What fitness to practice means, how the process works, and what is being assessed at each stage.
Restoring confidence after a concern — with patients, with colleagues and with the regulator.
This course. The professional duty, the four things it requires, delay and partial disclosure —
and the evidenced remediation that answers a candour concern.
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Instant access on purchase. Certificate on completion, CPD certified by The CPD Certification Service.
by any UK healthcare regulator. This course covers professional standards and openness when things go wrong.
No course determines the outcome of a fitness to practice case. This is not legal or regulatory advice
— if you are facing a fitness to practice matter, or deciding what to disclose and when, take
advice from your indemnity provider, defence organisation, professional body or a specialist regulatory
adviser about your own circumstances before responding to anyone.
