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Standards in practice: being open when things go wrong

04 Jul 2019

The duty of candour is important for anyone working in health and care, but what does it mean in practice?

In January, the Professional Standards Authority (PSA) published a report, Telling patients the truth when something goes wrong.

The report discussed how regulators approach the professional duty of candour. This is the duty to be open and honest with service users when something goes wrong with their treatment or care.

‘Telling patients the truth’

The PSA reported that regulators have already taken positive steps to help embed the duty of candour in health and social care, such as by including the duty of candour in standards of practice and standards for education and training.

The report also emphasised that regulators, employers, education providers and registrants all have a responsibility to embed the duty of candour.

The duty of candour

Being open and transparent with service users is an important part of building a professional relationship. It also helps to maintain public confidence in healthcare professions.

The importance of the duty of candour is reflected in standard eight of our Standards of conduct, performance and ethics: ‘Be open when things go wrong’.

The standards require you to:

  • Be open and honest with the service user when something has gone wrong. This means telling them what has happened truthfully, fully and promptly. You should also explain any likely effects and consequences of what has happened.
  • Apologise. Apologies can make a huge difference to the service user and can help build relationships of trust and mutual respect. Some registrants worry that an apology may be seen as an admission of wrongdoing or might negatively impact their career. But apologies are an important part of professional practice and are not an admission of legal liability. This is reiterated in our revised Sanctions policy, which will be published on our website on Monday 15 July.
  • Take action to put things right where possible. Sometimes it will be appropriate to offer the service user support or a remedy in relation to what has happened. If you are employed you should also follow your employer’s arrangements for incident reporting and notification.

We understand that responding to concerns and complaints when something has gone wrong can be stressful.

As with all our standards, we expect you to use your professional judgement and to be able to justify your decisions and actions if asked. Your employer, if you are employed, and your professional body or union, if you are a member, should also be able to provide support and guidance.

Our approach to candour

The PSA’s report found that more could be done to highlight the importance of the duty of candour. We responded to this report in a paper to our Council where we outlined a number of actions we will take to further our work in this area.

We have recently commissioned research into clinical and peer supervision. This research will help us to develop resources for registrants and employers on providing effective supervision. We hope that this might help to create environments which support you to be candid.

We are also:

  • developing more online resources and guidance, such as those on our Meeting our standards web pages, which will include specific resources on candour;
  • investigating how we might emphasise the importance of candour in our communications and processes; and
  • exploring how we can use data in this area.

We will share updates on our progress on our website.

Page updated on: 26/03/2021