Duty of Candour in Healthcare Practice

This duty of candour training covers when and how to be open with a patient when something has gone wrong in their care, and how to do it well. It covers two duties side by side. The first is the professional duty of candour that every UK registered healthcare professional owes. The second is the separate statutory duty on organisations in England, Scotland and Wales.

The course draws on the joint GMC and NMC guidance Openness and honesty when things go wrong: the professional duty of candour, first published in 2015 and refreshed in 2022, and on the standards of the other UK healthcare regulators. It is self-paced, estimated at about 2 hours, and ends with a scenario assessment and a written reflective account. You can see it with the rest of our titles in the course catalogue.

The core of the duty, as the course sets it out: tell the patient, apologise, offer a remedy or support to put things right where possible, and explain the short and long-term effects. The duty applies whether you made the error, were part of the team, or simply found out what happened.

The duty is shared across the professions, so the course is written for all of them. Its examples include a practice nurse, a GP registrar, a pharmacist, a midwife, a care home nurse, a physiotherapist and an optometrist. It suits:

• Any registrant who wants confidence in the words to use, and the words to avoid, when something goes wrong.
• Clinical leads and managers, since a whole section deals with barriers to openness, psychological safety and the leader's role.
• Registrants facing a concern that involves delayed disclosure, a defensive response or a failure to report. Concealment is often treated as more serious than the original error.
• Teams in multidisciplinary settings, where everyone can assume someone else will speak to the patient.

1. Understanding the duty of candour. What it means, why it matters, when it applies (including near misses), candour in everyday practice, and its roots in autonomy, beneficence, non-maleficence and justice. A table tests real situations against the duty.
2. Guidance from the regulators. The 2014 joint statement by the regulators' chief executives and what each regulator's standards say. It explains why concealment raises integrity questions, and how the statutory duty works: regulation 20 in England, the 2016 Act in Scotland (in force from April 2018) and the 2020 Act in Wales (in force from April 2023). It covers the legal status of an apology under section 2 of the Compensation Act 2006 and the Apologies (Scotland) Act 2016, and reporting through Learn from Patient Safety Events and the Yellow Card scheme.
3. Being open when things go wrong. Why timeliness matters, how to prepare for and structure a candid conversation, how to apologise without blame, how to reassure without false promises, and how to handle situations where the patient lacks capacity, has died or does not want details.
4. Reflection and insight after an incident. What insightful reflection looks like, guiding questions, building a habit of reflection, and a weak-versus-strong reflection table you can measure your own writing against.
5. Team culture and leadership. Psychological safety, just culture, barriers to openness, what candour-supportive leaders do, supporting colleagues after an incident, and small habits that embed openness.

The professional duty comes from regulators' standards. The statutory duty comes from legislation. The course keeps the two clearly apart, because meeting one does not discharge the other.

For how candour fits each regulator's wider expectations, see our GMC page and NMC page.

Candour concerns usually come up in two ways. A professional delayed or avoided telling a patient. Or the response to an error, such as altering a record or discouraging a report, became the main concern. In either case, regulators look at your insight and what has changed since, not just whether you have completed training.

The course's reflection section is built for this. It contrasts weak reflection ("communication could have been better") with strong reflection that names the delay, its effect on the patient, your own part, and the specific routine you now follow. It then pairs that with evidence, such as a supervisor's review of your practice over several months. The NMC's guidance on insight and strengthened practice and the HCPTS practice note on impairment both look forward: whether you understand what went wrong and whether the risk of it happening again has been dealt with.

• Write your reflection after the course, in your own words, without patient identifiers. The reflective statement builder gives you a structure.
• Keep the certificate with the reflection and any evidence of changed practice.
• Take advice from your defence organisation, indemnity provider or union about what to submit and when.

If the concern was about communication or the handling of a complaint, the communication and complaints pathway shows the full pack. Where it touches honesty or public trust more widely, see the conduct and trust pathway.

The course ends with a 15-question scenario-based assessment. The pass mark is 12 out of 15 (80%). If you score lower, the course points you back to the sections behind the questions you missed so you can try again. When you pass, you can download a certificate of completion issued by Healthcare Practise UK. The course itself says plainly that passing supports your learning record but does not, on its own, demonstrate insight or remediation.

The assessment questions are practical scenarios. One example is a double dose of anticoagulant on your shift, where the patient is stable: what should happen first? Another is a wrong medicine caught before it reaches the patient. For NMC revalidation, self-directed learning like this usually counts as individual CPD unless you complete it with others. Doctors bring it to appraisal with their reflection. Other regulators set their own rules, so check yours.

• Ensuring Effective Communication as Healthcare Professionals: the communication skills that sit underneath a good candid conversation.
• Ensuring Dignity and Non-Discrimination: respect and fairness when emotions run high.
• How to Avoid a Complaint or Investigation: the preventive habits that stop small problems becoming formal complaints.

The Communication and Candour Pack combines these with this course, the course on dealing with a complaint and our Reflection module. If you are unsure which mix fits your situation, try the which course do I need tool.