Duty of Candour

Aim of the Course

This course aims to help frontline health and social care workers understand duty of candour and respond appropriately when care does not go as intended.

It promotes honest communication, timely reporting, compassionate support and a positive learning culture focused on improving safety rather than concealing mistakes.

Scope of the Course

The course provides role-appropriate awareness for healthcare assistants, care assistants, support workers, senior carers and similar frontline staff working in England.

It explains the difference between openness in everyday practice, the statutory organisational duty and the professional duty applying to regulated healthcare professionals. It does not qualify learners to decide independently whether an incident meets the statutory notification threshold or to lead a formal duty-of-candour process.

What This Course Covers

The course covers:

1. The meaning and purpose of duty of candour
2. Openness, honesty and transparency in care
3. Statutory, organisational and professional responsibilities
4. Incidents, near misses and notifiable safety incidents
5. Immediate action following an incident
6. Reporting and escalation responsibilities
7. Communicating compassionately with people and families
8. Apologies, explanations and reasonable support
9. Accurate, factual and confidential record-keeping
10. Speaking up, responding to concerns and learning from incidents
11. Common barriers to candour and unsafe responses
12. Applying duty of candour principles in realistic care situations

6. Learning Outcomes

By the end of the course, learners should be able to:

1. Define duty of candour in a health and social care context.
2. Explain why openness, honesty and transparency matter when care goes wrong.
3. Distinguish between the statutory organisational duty and an individual worker’s responsibilities.
4. Recognise incidents, omissions and near misses that must be reported.
5. Describe why frontline workers should escalate an incident rather than independently decide whether it meets the legal notification threshold.
6. Take appropriate immediate action to protect and support the person affected.
7. Report concerns promptly through the correct workplace procedure.
8. Communicate honestly, respectfully and compassionately within the limits of their role.
9. Explain the purpose and essential features of a meaningful apology.
10. Produce factual, timely and confidential incident-related records.
11. Identify poor or obstructive responses that undermine candour.
12. Describe how incident reporting and learning can improve future care.
13. Apply duty-of-candour principles to common frontline care scenarios.

7. Further Reading and References

Legislation and regulations

1. Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, Regulation 20 — Duty of Candour. This is the principal statutory organisational duty applying to CQC-registered providers in England. UK legislation: Regulation 20
2. Health and Social Care Act 2008 (Regulated Activities) (Amendment) Regulations 2015. These regulations extended the relevant duty-of-candour requirements to other CQC-registered providers. UK legislation: 2015 amendment

Regulatory and national guidance

1. Care Quality Commission — Regulation 20: Duty of Candour. Provider guidance should be used to interpret and apply the statutory requirements, including the meaning of a notifiable safety incident.
2. Department of Health and Social Care — Duty of Candour Review. Confirms that the statutory duty applies to CQC-registered health and social care organisations in England and distinguishes it from the professional duty. GOV.UK duty-of-candour review
3. NHS England — Patient Safety Incident Response Framework. Provides the NHS approach to compassionate engagement, proportionate incident response, learning and improvement. It is particularly relevant to NHS-funded healthcare services. NHS England PSIRF
4. NHS England — Engaging and Involving Patients, Families and Staff Following a Patient Safety Incident. Provides practical guidance on compassionate engagement with people affected by patient safety incidents. NHS England engagement guidance

Professional standards and workforce guidance

1. Nursing and Midwifery Council and General Medical Council — Professional Duty of Candour Guidance. Relevant to registered nurses, nursing associates, midwives and doctors; it is distinct from the provider’s statutory duty. NMC professional duty of candour
2. Skills for Care — Code of Conduct for Healthcare Support Workers and Adult Social Care Workers in England. Sets expectations concerning accountability, open communication, reporting unsafe practice and maintaining accurate records. Skills for Care Code of Conduct

Accuracy note: This course should be presented as applying primarily to England, because Regulation 20 and CQC regulation are England-specific. Scotland, Wales and Northern Ireland have different regulatory and legal arrangements.