NMC Code Section 14: Duty of Candour

Section 14 of the Code is the duty of candour.

“Be open and candid with all service users about all aspects of care and treatment, including when any mistakes or harm have taken place.”

Sub-clauses:

• 14.1 Act immediately to put matters right, if possible.
• 14.2 Explain fully and promptly what has happened and the likely effects.
• 14.3 Document all such events.

Section 14 sits alongside the statutory duty of candour, introduced for organisations in 2014. The Code’s professional version applies to individual registrants regardless of whether the statutory trigger has been met.

What it means in practice

Three things happen when an incident occurs:

Immediate action. If the harm can be reversed or limited, that comes first. Stop the medication, summon help, apply the antidote, treat the consequence.

Open conversation. Tell the patient (and family where appropriate) what happened. Apologise. Explain what’s being done. Don’t minimise.

Documentation. Record what happened, what was done, what was said. Submit an incident report.

The harder of these for many nurses is the conversation. There’s a fear that openness will lead to complaint, litigation, regulatory action. The evidence shows the opposite: patients and families who feel respected and informed are less likely to escalate. The NMC’s own guidance and NHS Resolution’s research both confirm this.

Common breaches

• Concealment: not telling the patient something has gone wrong, hoping it won’t be noticed.
• Delay: knowing about an incident and waiting to disclose, especially in the hope it can be quietly fixed.
• Inadequate apology: using language (“it’s just procedure”, “this sometimes happens”) that minimises rather than acknowledging.
• Failure to document: events recorded only in incident systems without entries in the clinical record.

The Mid Staffordshire and Morecambe Bay inquiries both identified failures of candour as systemic and contributing to lasting harm.

CPD that maps to Section 14

• Duty of candour training (mandatory in NHS trusts, often annual).
• Having difficult conversations / breaking bad news.
• Incident reporting and Datix-style systems.
• Root cause analysis.
• “Being open” frameworks (NHS Resolution).
• Restorative practice and just culture training.

Common reflective account themes

Strong Section 14 accounts describe:

• An incident you were involved in, the candour conversation that followed, and what you learned about handling such conversations.
• A moment where you considered whether to disclose something and worked through the decision.
• A team’s response to an incident where candour was modelled well.
• A change in practice after a candour conversation revealed a system issue.

Where Section 14 connects to other sections

• Section 2 (listen and respond): candour includes hearing the patient’s account.
• Section 5 (privacy and confidentiality): candour respects but doesn’t override confidentiality.
• Section 16 (act on safety risks): the system issue uncovered by an incident often requires Section 16 action.

The next chapter covers Code Section 15: providing help in emergencies.