Updated guidance on meeting the duty of candour

Published: 11 March 2021 Page last updated: 12 May 2022

We have updated our guidance for providers on Regulation 20 - the duty of candour.

This is to make it clear what providers must do to meet the requirements of the regulation and the circumstances in which it must be applied.

The duty of candour was introduced in 2014 in response to concerns raised following investigations into Mid Staffordshire NHS Foundation Trust. It also followed a tireless campaign by the parents of Robbie Powell who sadly died in 1990 and whose case highlighted the need for a statutory duty of candour.

The regulation puts a legal duty on all health and social care providers to be open and transparent with people using services, and their families, in relation to their treatment and care.

It also sets out some specific actions that providers must take when a notifiable safety incident occurs. These include:

  • informing the people affected about the incident
  • offering reasonable support
  • providing truthful information and a timely apology.

Our updated guidance gives a more specific explanation of what is defined as a notifiable safety incident and examples covering a range of scenarios. And, it makes clear that the apology required to fulfil the duty of candour does not mean accepting liability and will not affect a provider’s indemnity cover.

The guidance will support providers in all sectors to fully understand the duty and know what they have to do to carry it out. In turn, this will have a positive impact on people using those services.

Ted Baker, CQC’s Chief Inspector of Hospitals, said:

“The duty of candour is a crucial part of a positive, open and safe culture. People using any type of health or social care service have a right to be informed about all elements of their care and treatment - and, all providers have a responsibility to be open and honest with those in their care.

“Where the duty of candour is not being carried out properly, there can often be wider concerns around a lack of transparency, staff not feeling able to speak up and mistakes not being learned from.

“Candour is integral to a ‘just culture’ and it is vital that we help providers get this right. Candour cannot be an ‘add on’ or a simple matter of compliance - it will only be effective as part of a wider commitment to safety, learning and improvement.

“Good progress has been made by many providers, but more needs to be done to ensure that the culture of openness is fully embedded.  CQC will keep its focus on this essential element of a safe culture going forward and we have updated the guidance for providers to help them drive further improvements.”

Commenting on the guidance, Helen Vernon, Chief Executive of NHS Resolution, said:

“NHS Resolution fully supports the CQC’s updated Duty of Candour guidance.

“Through our own guidance, Saying Sorry, we encourage an early apology when something goes wrong. This is not an admission of liability, is always the right thing to do and is the first step to learning from what happened.

“The CQC guidance is a valuable resource to enable a clear understanding of how the duty of candour applies in healthcare.”

We have produced this guidance with input from providers, inspection staff, and other stakeholders.

We have also updated our internal guidance on duty of candour and will be rolling out a programme of training for inspectors to support this.

The duty of candour is a crucial part of a positive, open and safe culture.

Ted Baker, Chief Inspector of Hospitals