GPAtlasWhat it covers
The legal duty on every GP practice to be open with patients, and the exact steps after a notifiable safety incident: telling the patient in person, a true account, an apology, a letter, records and support. The professional duty each clinician carries, what reception does when someone says care went wrong, how candour runs alongside complaints, speaking up and incident reporting, and how practices record and learn from patient safety events.
Who it is for
Everyone in a GP practice: reception and administration, healthcare assistants, nurses, pharmacists, GPs, trainees and locums. Parts are written for the clinicians who speak to patients and for the practice manager and partners who run the process.
By the end you will be able to
- Explain the statutory and professional duties of candour and whom each applies to.
- Decide whether an incident meets the notifiable safety incident threshold for a GP practice.
- Describe what must be done and when: in person, apology, true account, letter, records, support.
- Apologise well, knowing the law requires it and does not treat it as admitting negligence.
- Respond at reception, in person or by phone, when someone says their care went wrong.
- Run candour alongside complaints, speaking up and incident reporting, and record events on LFPSE.
Modules
- When the legal duty applies
- Telling the patient, step by step
- Your part, whatever your role
- Reporting and learning afterwards
This course covers the law in England, where CQC regulates the duty. Your practice's own candour or being open policy names who does what where you work.
Content mapped to regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, CQC's regulation 20 guidance and GP mythbuster 32, and the GMC and NMC joint guidance on the professional duty of candour. Law named: Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 20.
Sources
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 20: duty of candour (current text, including paragraph (9), the threshold for providers that are not health service bodies)
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 2: interpretation (registered person, health service body, health care professional)
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 22: offences, including regulation 20(2)(a) and (3)
- Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, regulation 23: penalties, a fine up to level 4 on the standard scale
- Sentencing Act 2020, section 122: the standard scale of fines (level 4 is £2,500)
- Compensation Act 2006, section 2: apologies, offers of treatment or other redress
- Care Quality Commission (Registration) Regulations 2009, regulation 16: notification of death of a service user
- Care Quality Commission (Registration) Regulations 2009, regulation 18: notification of other incidents, including serious injury
- Regulation 20: Duty of candour, guidance for providers (Care Quality Commission, page updated 16 May 2025)
- Notifiable safety incidents (Care Quality Commission, guidance updated 30 June 2022): the three criteria, near misses, incidents found later or at another provider
- Examples of notifiable safety incidents, including general practice (Care Quality Commission)
- What you must do when you discover a notifiable safety incident: relevant person, records, reasonable support (Care Quality Commission)
- How we regulate the duty of candour: training, monitoring and direct prosecution (Care Quality Commission)
- Background to the duty of candour (Care Quality Commission)
- GP mythbuster 32: Duty of Candour and General Practice (regulation 20) (Care Quality Commission, updated 23 December 2022): training for all staff on communicating with patients about notifiable safety incidents
- GP mythbuster 24: Recording patient safety events with the Learn from patient safety events (LFPSE) service (Care Quality Commission, updated 23 December 2022)
- GP mythbuster 3: Significant event analysis (Care Quality Commission, updated 23 December 2022)
- Openness and honesty when things go wrong: the professional duty of candour, joint GMC and NMC guidance (in effect 29 June 2015, last updated 13 December 2024)
- The professional duty of candour (General Medical Council; read from the web archive copy, the live site blocks automated reading)
- Guidance on the professional duty of candour (Nursing and Midwifery Council)
- The Code, sections 10 and 14: records without falsification, and being open and candid when mistakes or harm happen (Nursing and Midwifery Council)
- Standards of conduct, performance and ethics, standard 8: be open when things go wrong (Health and Care Professions Council, effective 1 September 2024)
- Standards for pharmacy professionals, standard 8: speak up when they have concerns or when things go wrong (General Pharmaceutical Council)
- Saying sorry (NHS Resolution leaflet, 2023 edition): what to say, what to avoid, and cover is never refused because an apology was given
- The NHS Constitution for England (Department of Health and Social Care, updated 17 August 2023): the right to be told about a safety incident, and staff responsibilities
- Learn from patient safety events (LFPSE) service (NHS England; read from the web archive copy of July 2026): NRLS decommissioned 30 June 2024
- Primary care information on the learn from patient safety events service (NHS England; read from the web archive copy): what to record, and direct online recording by general practice
- Patient Safety Incident Response Framework (NHS England; read from the web archive copy of July 2026): primary care providers may adopt it, not yet a requirement
- Engaging and involving patients, families and staff following a patient safety incident, PSIRF supporting guidance, version 1 (NHS England, August 2022; read from the web archive copy)
- Primary care patient safety strategy (NHS England, 26 September 2024; read from the web archive copy): general practice to register with LFPSE and start implementing PSIRF
- NHS patient safety strategy: progress so far (NHS England, progress update July 2026, read through the site's own content feed): PSIRF being piloted in 200+ GP practices, wider primary care scoping planned in 2027
- Methotrexate once-weekly for autoimmune diseases: new measures to reduce risk of fatal overdose due to inadvertent daily instead of weekly dosing (MHRA Drug Safety Update, September 2020)
- Death of a person using the service: notification form (Care Quality Commission): primary medical services may report deaths through LFPSE and need not notify CQC separately
- Serious injury to a person using the service: notification form (Care Quality Commission, page updated 20 May 2025): only NHS trusts and NHS Blood and Transplant may use LFPSE instead
GPAtlas is not accredited, verified or endorsed by Skills for Health or NHS England. Acceptance of this training is at the discretion of your employer, who remains responsible for confirming it meets local requirements. Your employer may require more frequent refreshers than the guidance period; the practice's own policy applies. Some pictures and films in our courses, and the film narration, are made with AI tools. We check every one for accuracy before we publish it.