Recommendation F175: Candour about harm
From Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, published 6 February 2013.
Recommendation
Full and truthful answers must be given to any question reasonably asked about his or her past or intended treatment by a patient (or, if deceased, to any lawfully entitled personal representative).
In brief (written by this site)
In September 2024 commentary published in February 2026, the Department of Health and Social Care and NHS England reported that implementation was ongoing, noting that statutory regulators require health and care professionals to be open and honest about harm, with joint guidance updated in March 2022 (DHSC and NHS England, Feb 2026). Earlier, in May 2024, the Thirlwall Inquiry legal team recorded that the government had accepted the recommendation and that regulators had issued joint duty of candour guidance in 2015 (The Thirlwall Inquiry legal team, May 2024).
AI-generated summary of the record on this page, checked by a second model and automatic checks, 26 Sep 2026. The record below is the sources' own words.
About this summary
This recommendation applies across many organisations. The record reflects central policy activity; adoption in individual organisations may vary.
Government response
Accepted.
All regulated professionals through the principles that underpin their standards and codes of conduct are required to be open and transparent with patients in respect of discussions about treatment and care. As set out in recommendation 181, the General Medical Council and the Nursing and Midwifery Council will be working with the other regulators to agree consistent approaches to candour and reporting of errors, including a common responsibility across doctors, nurses and other health professions to be candid with patients when mistakes occur whether serious or not. The Department of Health will also ask the Professional Standards Authority to advise and report on progress with this work. The professional regulators will also review their guidance to panels taking decisions on professional misconduct to ensure they take proper account of whether or not professionals have raised concerns promptly.
How this response relates to the recommendation
Site note: This is volume two of "Hard Truths: The Journey to Putting Patients First" (Cm 8777-II), the government's response to the Inquiry's 290 recommendations, published by the Department of Health on GOV.UK on 19 November 2013 and dated to that day here. The PDF the row links to is the accessible edition, whose title page reads "January 2014". The Department of Health has been the Department of Health and Social Care since January 2018. The volume says it includes accounts from each of the national organisations the recommendations name, but it does not mark which passage each organisation wrote, so every row is filed under the Department that published it.
Blanket government agreement does not establish acceptance or delivery by each addressee. Some response passages cover groups of recommendations.
Scope of the government response
Government responded via "Hard Truths: The Journey to Putting Patients First" (2014), a single document covering all 290 recommendations with a blanket acceptance. Individual recommendation responses were not broken out.
Delivery
DHSC and NHS England say in progress (27 February 2026)
A joint statement of the statutory regulators has confirmed that every health and care professional must be open and honest with patients and people in their care when something that goes wrong with their treatment or care causes, or has the potential to cause, harm or distress. The joint duty of candour guidance by NMC and GMC was updated in March 2022 The General Medical Council (GMC) also publish guidance on shared decision making and consent. This includes information that doctors should give to patients when discussing their options.
Please see response to Recommendation 21 and 174 above regarding the statutory duty of candour.
Site note: DHSC and NHS England's own account of progress, supplied to the Thirlwall Inquiry in September 2024 and printed in the Inquiry legal team's Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version dated April 2025, published 27 February 2026). It is not a finding of the Inquiry. Their reviewed extent of implementation reads “Implemented - Ongoing”. Table row: section 18.2 No. 175, PDF page 510.
Department of Health and Social Care says in progress (11 February 2015)
Eight UK professional healthcare regulators published a joint statement in October 2014 which sets out a professional duty of candour. The statement clarifies what the regulators expect from health professionals wherever they work across the public, private and voluntary sectors. In addition, the General Medical Council and the Nursing and Midwifery Council have launched a public consultation on draft joint guidance which is designed to support doctors, nurses and midwives in fulfilling their professional duty to be open and honest about mistakes. The proposals cover the need to learn from ‘near misses’ as well as when something goes wrong and a patient is harmed. There is also advice on apologising to patients and those close to them. The draft guidance calls on clinical leaders and employers to support doctors, nurses and midwives by creating cultures in the workplace that are open, honest, and where people learn from mistakes so that future patients are protected from harm. The consultation closed on 05 January 2015 and the two professional regulators will aim to publish their new joint guidance in March 2015.
Site note: This is the supporting annex published on 11 February 2015 with "Culture change in the NHS: applying the lessons of the Francis Inquiries" (Cm 9009), attached to the GOV.UK page as "Culture change in the NHS supporting annex". The annex has no title page; that title is GOV.UK's and the PDF's own. Its table has four columns (No., Recommendation, Hard Truths Government response, Progress update), and the row carries the Progress update cell. No column says which organisation wrote an update, so the row is filed under the Department of Health (now the Department of Health and Social Care), which published it.
Site note: The Inquiry addressed this recommendation to healthcare providers, not to the Department of Health. The annex gives this update in the Department's publication and does not say who wrote it, so the row is the Department's report of the progress made on it.
What other bodies have found
In their own words. These do not change the delivery statement above.
Thirlwall Inquiry legal team (15 May 2024)
This recommendation was accepted by the Government.
In the January 2014 Hard Truths report, the Government said that all regulated professions, through their codes of conduct, were required to be open and transparent with patients in respect of discussions and treatment and care.
In the February 2015 Culture Change report, the government said that 8 UK professional healthcare regulators had published a joint statement in October 2014, which set out a professional duty of candour and clarified what the regulators expected from health professionals.
In 2015, the General Medical Council and the Nursing and Midwifery Council published joint duty of candour guidance.
Site note: The Thirlwall Inquiry legal team's own notes on implementation, from its Review of Implementation of Recommendations from Previous Inquiries into Healthcare Issues (version of 15 May 2024). The review does not colour its Extent of Implementation cell for this recommendation green; it leaves the cell uncoloured where a recommendation was rejected, where evidence of implementation was insufficient, or where steps had been taken but implementation was not yet complete. Table row: section 16.2 No. 175, PDF page 476.
Source
Responsible bodies
Themes and tags
Who has spoken
- Department of Health and Social Care
Response, delivery statement - DHSC and NHS England
Delivery statement - Thirlwall Inquiry legal team
Finding