Duty of candour explained

What the duty requires in England

Regulation 20 says a registered person must act in an open and transparent way with relevant persons about care and treatment ¹. When it becomes aware of a notifiable safety incident, it must notify the relevant person as soon as reasonably practicable and give reasonable support ¹.

The first notification must be given in person. It must give a truthful account of the facts known, say what further enquiries are planned, include an apology and be recorded in writing ¹. A written notification must follow, with the same account, the results of enquiries and an apology ¹.

The regulation defines an apology as an expression of sorrow or regret in respect of a notifiable safety incident ¹. The General Medical Council says the Care Quality Commission can prosecute breaches of parts 20(2)(a) and 20(3) ⁴.

What triggers it

• England, health service bodies. An unintended or unexpected incident that could result in, or appears to have resulted in, death, or severe or moderate harm or prolonged psychological harm ¹.
• England, other providers. A wider list, including impairment lasting at least 28 days and prolonged pain or psychological harm ¹.
• Scotland. An unintended or unexpected incident that, in the view of a registered health professional not involved in it, resulted or could result in death or listed harms ².
• Wales. Under the guidance, unexpected or unintended harm of a moderate degree or above. Near misses do not count ³.
• Victoria. A serious adverse patient safety event suffered during care ⁵.

Scotland and Wales

Scotland's duty falls on responsible persons, such as NHS Health Boards, independent health care providers, local authorities and care service providers ². They must follow the duty of candour procedure set by regulations, which may cover notice, an apology, a meeting and a review ². Each must publish an annual report that names no individuals ².

Wales's duty applies to NHS bodies and to primary care providers for NHS services ³. The guidance says the first notice must be by phone, video or in person and include an apology ³. A written follow-up is due within five working days. A notice given more than 30 working days after the body became aware must have its delay explained ³. Health boards and trusts publish annual reports by 31 October ³.

The apology is not an admission

Scotland's Act says an apology or other step under the procedure does not of itself amount to an admission of negligence or a breach of a statutory duty ². Welsh guidance cites regulation 13 to the same effect ³.

The Apologies (Scotland) Act 2016 does not apply to an apology made under the candour procedure ⁷. The candour Act carries its own rule ².

Organisational and professional duties

The statutory duty in England falls on organisations, not on individual staff. Organisations must train staff to understand it ⁴. The General Medical Council publishes separate guidance on the professional duty of candour for doctors ⁴.

In Victoria, patients and families receive an apology, the facts of what happened, the service's response and the steps taken to prevent a repeat, according to Safer Care Victoria ⁵.

A duty for public officials

The UK Public Office (Accountability) Bill would place a duty of candour, transparency and frankness on public authorities and officials, including in dealings with inquiries and investigations ⁶. It would create offences for misleading the public ⁶. Its parliamentary page, last updated 28 May 2026, shows a Commons report stage on 14 May 2026 ⁶.