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Duty of Candour

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In the first criminal prosecution of its kind, University Hospitals Plymouth NHS Trust was recently prosecuted and found to be in breach of the Duty of Candour for failing to be open and transparent with a bereaved family.

In this case, a patient died at Derriford Hospital after suffering a perforated oesophagus during an endoscopy.  

The Deceased’s daughter received a letter of apology for her mother’s death. However, she felt that the letter lacked remorse and left pertinent questions unanswered.

The Care Quality Commission (CQC) brought an action against University Hospitals Plymouth NHS Trust alleging that the Trust had not been open and transparent with the Deceased’s family about her death and had not apologised in a timely manner.

The Trust admitted its failings at Plymouth Magistrates Court and pleaded guilty for its failure to adhere to the Duty of Candour. The Trust was fined £12,565.00.

Nigel Acheson, the CQC’s deputy chief inspector of hospitals said: “All care providers have a duty to be open and transparent with patients and their loved ones, particularly when something goes wrong, and this case sends a clear message that we will not hesitate to take action when that does not happen.”

The added “patients and their families are entitled to the truth and a formal written apology as soon as practical after a serious incident, and the University Hospitals Plymouth NHS Trust’s failure to fulfil this duty is why the CQC took this action”.

What is the Duty of Candour?

The Duty of Candour is a statutory duty placed upon health care providers to be open and honest with patients and their families when something goes wrong that appears to have caused or could lead to significant harm, which is known as a ‘notifiable safety incident’.


The duty is contained in Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and applies to all health and social care organisations registered with the CQC in England.

The CQC is an independent regulator of all health and social care in England, which places a legal duty on all health care providers to adhere to these Regulations.

The purpose of the regulations is to ensure that all health care organisations are open and transparent with patients and their families in relation to care and treatment provided.

Following the occurrence of a notifiable safety incident, the health care provider must:

  • Notify the relevant persons of the incident and provide an explanation of the facts known at the time, what further enquiries will be made, offer an apology, and keep a written record of the incident.
  • Give the patient reasonable support; this could include practical support such as providing an interpreter or emotional support.
  • Give the patient written notes of the initial discussion and of the notification, including details of further enquiries, the results, and an apology.

Duty of Candour applies when any incident including unintended or unexpected incidents occur which results in:

  • Death (where the death relates directly to the incident)
  • Severe harm
  • Moderate harm
  • Prolonged psychological harm.

How we can help

The case against University Hospitals Plymouth NHS Trust enforces the importance of the duty on healthcare providers to be open and transparent with patients in cases where there has been an error in treatment.

It is an important case which provides reassurance that legal action can be brought against health care providers who fail to be open and transparent where things have gone wrong.

If you or a family member have been notified of a safety incident in relation to treatment, you may have a potential medical negligence claim. Contact our medical negligence team and speak to one of our experienced solicitors for free no obligation advice on 0121 355 0011.