The Duty of Candour - A guide for patients, families and carers

What is the duty of candour?

Duty of Candour is a specific legal obligation for NHS Organisations to be open and honest with the people who receive care and treatment. This is outlined in The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Duty of Candour applies if the care we provide has, or may have contributed to unexpected or unintended moderate or severe harm, or death.

NHS England has issued guidance on recording harm levels in patient safety events. The degree of harm recorded is related to the actual impact on a patient from the particular incident being reported. More information can be found on the NHS England website (opens in a new tab).

This means that if you suffer an unexpected or unintended harm which results in moderate or above harm during your care we will:

• tell you about it
• apologise
• investigate
• give an open explanation of what happened

Why do things go wrong?

We strive to provide high quality, safe and compassionate care to all of our patients. However, healthcare can be very complex and things can change rapidly and unexpectedly. Occasionally things do not go to plan and a patient can be harmed despite our best intentions. We regret every case of harm to our patients but we make sure we use the opportunity to learn how we might stop similar things happening again.

What can I expect?

• As soon as possible after the event, a member of staff will discuss what happened with you honestly and openly and talk to you about your condition and your ongoing care plan.
• All the facts may not be clear at this time so not all of your questions may be answered until we have investigated further.
• If you are not in a condition to receive the information, for example if you are too ill or recovering from an anaesthetic, staff will inform your next of kin or the person named by you in your healthcare record.
• You can of course, involve family members or carers in these discussions
• You will be treated with dignity and respect and you will receive an apology
• You can expect to be involved in and contribute to decisions made about your care
• You will normally be given a named person to speak to about any further queries or concerns
• We will investigate what went wrong and you will be informed about the findings
• You can expect confidentiality.

Should I have someone with me when staff talk to me about what happened?

• It is recommended that you should choose someone to support you during the discussion. This should be somebody whom you are comfortable with, can talk to easily and whom you do not mind hearing personal information.
• Please let us know if you wish somebody to be with you for the discussions. An advocate can be arranged for you if required.
• Please remember that when something goes wrong it is distressing for everyone involved including the members of staff.

Who will speak to me about what happened?

• One or more staff members may talk to you, depending on what happened.
• Usually the person leading the conversation will be the person from your healthcare team who knows the most about what happened and will be able to answer any questions you may have.

What to consider during the conversation?

• Think about what questions and fears or concerns you have in relation to: what has happened, your condition and your ongoing care.
• Write down any questions or concerns you have.
• Think about whom you would like to have with you to support you.
• Think of what things may assist you in moving forward.

You may require further discussions with your healthcare team to help you understand what has happened. Please do not hesitate to ask staff to help you arrange a further conversation.

What happens next?

• Further meetings may be necessary if all of the information you need is not available.
• We will tell you our findings and offer you a copy of any report. We can meet with you to discuss the report if you would find that helpful.
• We aim to complete incident reviews within 60 days, but please note that more complex investigations can take longer to be completed.
• If you are not satisfied with your care or your concerns have not been addressed by the investigation, we can investigate further and you also have the right to make a complaint. In the first instance please contact the Patient Advice and Liaison Service (PALS) and complaints department:
  • Telephone: 01223 216756 (Monday to Fridays, 9am-4pm)
  • Email the CUH PALS team
  • Walk-ins: PALS is located near the main Addenbrooke’s hospital reception (Monday to Fridays, 9am-4pm

Further sources of support

Cambridge University Hospitals NHS Foundation Trust‘s spiritual care

The chaplaincy is a confidential service available 24 hours a day to all patients, families and carers. It offers help on all aspects of pastoral care to members of all faiths or those of no particular religious belief.

Telephone: 01223 217769

Email the Chaplaincy

Healthwatch

Healthwatch England is the national ‘consumer champion’ for health and social care and works to share information, expertise and learning in order to improve health and social care services.

Healthwatch website

Total Voice Advocacy

Independent advocacy services to support people in resolving issues or concerns they may have about healthcare services.

Total Voice Advocacy Website

Email: Total Voice Advocacy

Tel: 0300 222 5704

Carers UK

Free expert advice, information and support on issues including financial and practical matters related to caring.

Carers UK Website (opens in a new tab)

Telephone: 08088087777

Cruse Bereavement Care

Provides support to those who have experienced the death of a close friend or relative.

Cruse Bereavement Care Website (opens in a new tab)

Telephone: 08444779400

Email the cruse helpline

Further information

Language support services – If you need an interpreter or information about your care in a different language or format, please contact our interpreting services.

Tel: 01223 256998 (option 2)

Email the CUH interpreting team.

For more information visit the CUH Accessible Information - translation services section on our website.

The full guideline on duty of candour is available on the CQC website (opens in a new tab).

This leaflet was originally adapted from, Guy’s and St Thomas’ NHS Foundation Trust.