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The duties of candour: what do they mean to paediatricians?
  1. Toby Reynolds1,
  2. Deirdre Kelly2
  1. 1The Liver Unit, Birmingham Childrens Hospital, Birmingham, UK
  2. 2Department of Anaesthesia, Royal London Hospital, London, UK
  1. Correspondence to Professor Deirdre Kelly, The Liver Unit, Birmingham Childrens Hospital, Steelhouse Lane, Birmingham, B4 6NH, UK; Deirdre.Kelly{at}

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The duty of candour is a duty to be open and honest. New professional and statutory obligations have strengthened the requirement for candour for doctors and their organisations following the Mid Staffordshire Inquiry. In this article we explain what the new duties are for the practising paediatrician and the organisation. Although the new guidance may appear daunting, health professionals should be reassured that it intends to support and strengthen their professional practice and create a more open culture to improve transparency and patient care.

What are the new duties and how did they come into being

Doctors have always had a duty to be open and honest with their patients. However, when things go wrong, doctors haven't always been good at either disclosing facts or apologising to patients, and unfortunately history suggests that being fully open is quite rare.1

The duty of candour goes beyond simply avoiding dishonesty. In UK public administrative law, the duty of candour is a duty to the court for public authorities to explain ‘fully what they have done, and why they have done it’.2 In this line of reasoning, paediatric surgeon and legal expert Robert Wheeler suggests that in healthcare ‘candour is needed to put the patient in the same position as the doctor, in terms of what clinical events have taken place.’3

The renewed focus on this duty comes after the Mid Staffordshire Inquiry finding that a ‘lack of candour was a significant element in the dysfunctional organisational culture at the Trust’.

However, patients and relatives have long fought for greater openness after harm or death. Campaigns by Will Powell, following the death of his son Robbie in 1990 of untreated Addison's disease, and by the charity Action against Medical Accidents, have been instrumental in this.

In particular, Powell's campaign highlighted the position in law prior to introduction of the statutory duty of …

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  • Contributors DK and TR thank all those who provided advice, guidance and contributions to this article, particularly Mary Agnew at GMC; Paul Bate and James Titcombe at CQC; Peter Walsh at AvMA; Alison Taylor, Children's Liver Disease Foundation and Michael Cumper, Somerville Foundation.

  • Competing interests DK is a current Member of the GMC Council and was a Commissioner on the CQC, 2008–2013. TR was National Medical Director's Clinical Fellow at GMC prior to resuming specialist training.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • i The organisational duty for primary care is slightly different for primary care at the time of writing. The authors consider that further developments in this area are likely and advise readers to consult the CQC website for further details.

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