Duty of candour: what care providers must do

Governance · October 2026 · 3 minute read

The duty of candour, set out in Regulation 20, requires every CQC-registered provider to be open and honest when something goes wrong with someone's care. When a notifiable safety incident happens, you must tell the person, or the person acting for them, as soon as reasonably practicable, apologise, explain what you know, follow up in writing and keep a record. The legal duty sits alongside a wider expectation that staff are open about all mistakes, not just serious ones.

What counts as a notifiable safety incident

For providers that aren't NHS bodies, which includes most care services, a notifiable safety incident is an unintended or unexpected incident during care that, in the reasonable opinion of a health care professional, appears to have caused, or could result in:

• the death of the person, where it relates to the incident rather than the natural course of their illness;
• an impairment of sensory, motor or intellectual function lasting, or likely to last, at least 28 days in a row;
• changes to the structure of the body;
• prolonged pain or prolonged psychological harm, lasting or likely to last at least 28 days in a row;
• a shortened life expectancy;
• or needing treatment to prevent death or any of the injuries above.

NHS bodies use different thresholds, based on moderate and severe harm, so be careful when reading guidance written for hospitals.

The steps you must take

1. Tell them, in person, as soon as reasonably practicable.
One or more representatives of the service should meet the person, or their representative, and give:

• an account of what happened, true to the best of your knowledge at that time;
• an explanation of what further enquiries you will make;
• an apology.

Offer them reasonable support, and keep a written record of the conversation.

2. Follow up in writing.
The written notification must repeat the account, set out the enquiries you'll make, include the results of any enquiries already made, and contain an apology.

3. Keep records.
Keep copies of all correspondence. If you can't reach the person, or they don't want to talk, keep a record of your attempts.

An apology, in the regulation's words, is "an expression of sorrow or regret". Saying sorry is not the same as admitting liability.

Who is the "relevant person"?

Usually the person receiving care. It can be someone lawfully acting for them if they have died, if they are under 16 and not able to make decisions about their care, or if they are 16 or over and lack capacity for the matter.

Making it work in practice

• Decide quickly whether it's notifiable. Build the question into your incident process so a clinician makes the call and records why.
• Name who does it. Usually the registered manager, with the right clinician alongside.
• Use a template for the letter, so nothing is missed under pressure.
• Track it. Every notifiable incident should show the date you became aware, the date you told the person, the date of the letter, and the outcome of the review.
• Share the learning. Candour works best when staff see that openness leads to better care, not blame.

How Eviqa Assure helps

Eviqa Assure records incidents and their review in one place, and helps you track each duty of candour step to completion, so you can show exactly what you did and when. Book a demo to see it.

Sources

• CQC: Regulation 20, duty of candour (in full) (opens in a new tab)
• CQC: Regulation 20, duty of candour (opens in a new tab)

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