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Duty of candour

The duty of candour, which was introduced by the government through Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, applies to dental practices from 1 April 2015.

How it affects you

Under the terms of the new duty, you need to make sure that your practice acts in an open and transparent way:

  • With relevant people
  • In relation to care and treatment provided
  • To service users
  • In performing a regulated activity.

After becoming aware that a notifiable safety incident has occurred, you must:

  • Notify the relevant person as soon as is reasonably practicable (CQC guidance refers to the ten days required by the NHS standard contract)
  • Provide reasonable support, such as providing an interpreter for any discussions, or giving emotional support to the patient.

Your notification must:

  • Be given in person by at least one representative of the practice involved
  • Provide a true and accurate account of the incident
  • Provide advice on what further enquiries into the incident are required
  • Include an apology
  • Be recorded in a written record, which should be kept securely.

What is a notifiable safety incident?

According to the regulations:

"In relation to a health service body, "notifiable safety incident" means any unintended or unexpected incident that occurred in respect of a service user during the provision of a regulated activity that, in the reasonable opinion of a health care professional, could result in, or appears to have resulted in:

(a) the death of the service user, where the death relates directly to the incident rather than to the natural course of the service user’s illness or underlying condition, or

(b) severe harm, moderate harm or prolonged psychological harm to the service user."1

What is harm?

“Harm” is further defined as:

  • Severe harm – permanent lessening of bodily, sensory, motor, physiologic or intellectual functions. This includes removal of the wrong limb or organ or brain damage. As with death, it must be directly related to the incident, and not the natural course of the underlying illness or condition.
  • Moderate harm – this means significant, but not permanent, and needing a moderate increase in treatment (this includes unplanned further surgery, readmission, a prolonged care episode, extra inpatient or outpatient time, cancelled treatment or transfer to another treatment area (ITU)).
  • Prolonged psychological harm – psychological harm the patient experiences (or is likely to experience) for a continuous period of at least 28 days.

About the duty of candour

The key principle of the duty of candour is that care organisations have a general duty to act in an open and transparent way in relation to care provided to patients. The statutory duty applies to organisations, not individuals.

Further information

The Care Quality Commission, Guidance for NHS bodies on the Fit and Proper Persons Requirement for Directors and Duty of Candour (2014)


  1. The Health and Social Care Act 2008 (Regulated Activities) Regulations 2015, paragraph 8