The Duty of Candour is a fundamental ethical and legal requirement for all doctors in the UK. It’s essentially the professional obligation to be open and honest with patients when something goes wrong with their care that causes (or has the potential to cause) harm or distress.

The GMC (General Medical Council) and the NMC (Nursing and Midwifery Council) actually have a joint guidance on this because it's so central to patient safety and trust.

The Professional Duty of Candour

According to the GMC, if a patient under your care has suffered harm or distress, you must:

• Tell the patient (or their advocate/family) that something has gone wrong.
• Apologize to the patient. A professional apology is not an admission of legal liability; it is an expression of regret for what has happened.
• Offer an appropriate remedy or support to put matters right (if possible).
• Explain fully the short-term and long-term effects of what has happened.

When does it apply?

The duty is triggered when an "adverse incident" occurs. This includes:

1. Near misses: Even if no harm actually reached the patient, if there was a significant risk of it, you should generally be open about it.
2. Psychological harm: It’s not just about physical injury; emotional distress counts too.

The Statutory Duty of Candour

While the professional duty applies to individual doctors, there is also a statutory (legal) duty that applies to healthcare organizations in England (regulated by the CQC). This kicks in when an incident meets a specific threshold of "moderate harm," "severe harm," or death.

Key Point: Saying "I am sorry" is a requirement of the GMC. It is widely recognized that an early, honest apology can actually prevent complaints from escalating into litigation.

I'll pull up some specific GMC guidance lessons and a flowchart to help you visualize how to handle these tricky clinical situations.

It's important to remember that the duty of candour isn't just about the conversation with the patient; it's also about the culture of safety within the NHS. When things go wrong, we use systems like Datix to report incidents so the whole organization can learn and prevent it from happening again.

I've found a great lesson on Truth-telling and disclosure which covers the ethical backbone of these conversations. I'll also put together a quick summary table of the steps you should take when an error occurs to keep it clear for your AKT revision.

The table above summarizes the key steps you'll need to know for the AKT. The GMC is very clear that apologizing is not an admission of liability—it's a professional requirement.

For your revision, it's also worth remembering that the Statutory Duty of Candour (the legal one for organizations) requires a written apology and a formal investigation report to be shared with the patient.

Would you like to try a quick game to see if you can categorize different scenarios as needing a formal Duty of Candour response, or maybe some practice questions on this topic?