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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
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Duty of candour

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Synopsis

Respond openly, promptly and compassionately when care causes or may have caused harm, while distinguishing every clinician’s professional duty from the different organisational candour regimes in each UK nation.

  • Put the patient’s immediate clinical needs first, then explain what is known, what remains uncertain and what will happen next. Candour is not delayed until an investigation proves fault.
  • Give a sincere apology. An apology acknowledges the patient’s experience and regret; it is not, by itself, an admission of legal liability.
  • Tell a senior clinician and activate the local incident and candour process, but do not delegate away your own professional responsibility to be honest with the patient.

Reasoning priorities

01
Immediate harm assessment

Identify treatment, monitoring and support required because of the event.

Assess the patient clinically and mitigate continuing risk before reconstructing causation. State what is attributable, possible or not yet known without minimising symptoms.

Worked reasoning

Worked caseDelayed recognition after an abnormal result

A clinician discovers that an abnormal result was filed without action six weeks earlier. The patient is clinically stable but now needs urgent further assessment.

  1. Contact the patient promptly using a safe method, arrange the needed clinical assessment and alert an appropriate senior. Verify the result, chronology and immediate management without waiting for the incident investigation.
  2. Explain in plain language that the result was not acted on when it should have been, what is known about possible consequences and what remains uncertain. Give a sincere apology and invite questions.
  3. Activate the provider’s incident and organisational candour route under the correct national framework. Offer practical and emotional support, communication adjustment and a clear way to contribute to the review.
  4. Final action: agree a named clinical plan and written follow-up, including who will communicate investigation findings. Do not speculate about individual blame or imply the patient must complain to obtain answers.
  5. Verification: document the disclosure and apology, confirm that urgent assessment and incident notification were received, update the patient when evidence changes and escalate if either clinical care or organisational response stalls.
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Sources and review status6 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Apply principles in context and verify current guidance when a decision affects care. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom