Focused Reflection on Candour (CPD 24-25)

For the 2024/25 CPD year, all registrants will be required to complete a focused reflection on their professional duty of candour. This refers to the requirement for health professionals to be open and honest with patients (i.e. people in their care) when something goes wrong with their treatment or care which causes or has the potential to cause harm or distress (Regulators Joint Statement on Candour (2014)), and directly relates to Principle B and Standard B7 in The Code (2016):

Principle B: You must act with honesty and integrity at all times and uphold high standards of professional conduct and personal behaviour to ensure public confidence in the profession. You must be guided in your behaviour and practise at all times by the principle that the health and well-being of a patient comes first. You must follow procedures set down by the regulator. 

Standard B7: Fulfil the duty of candour by being open and honest with every patient. You must inform the patient if something goes wrong with their care which causes, or has the potential to cause, harm or distress. You must offer an apology, a suitable remedy or support along with an explanation as to what has happened.

Fulfilling the duty of candour helps ensure the development of a professional culture in which safety is paramount, and openness and honesty are shared and acted on. Thus, other standards in The Code are relevant in reinforcing standard B7: 

Standard A3: Take appropriate action if you have concerns about the safety of a patient. 

Standard F1: Explore care options, likely outcomes, risks and benefits with patients, encouraging them to ask questions. You must answer fully and honestly, bearing in mind patients are unlikely to possess clinical knowledge. 

Our expectations for 2024/25

As part of your CPD return for 2024/25, the information you submit to us, by 31 August 2025, must include self-reflection on your familiarity with the principles of candour, and how you integrate them into your practice. We want you to tell us how your knowledge and practices could be strengthened and how you will maintain them in future. You will be asked to consider: 

1. Reflect on the extent to which you are familiar with your professional duty of candour.  
2. How do you currently integrate the principles of candour into your day-to-day interactions with patients? 
3. How could your knowledge and practices regarding candour be improved or strengthened? 
4. How will you ensure your knowledge and practices around candour remain current?

Candour Guidance

You may find it helpful to refer to our Candour Guidance, which was updated in September 2023 to emphasise the importance of apology as a crucial part of candour and the fact that adverse events can apply to advice or information provided as well as injury arising from hands-on care, and to provide new advice regarding near-miss events. 

Candour Toolkit

Furthermore, the GCC Candour Toolkit includes tips for supporting candour, such as effective communication, active reflection and safety incident reporting. The toolkit includes scenarios to help you reflect on how you apply the principles of candour in your everyday clinical practice, and thereby identify where your knowledge and practices regarding candour may be strengthened.

Scenarios

To help you reflect on Candour and how it could affect your clinical practice, we have prepared the following real-life scenarios for you to consider. A new scenario will be shared in the monthly newsletter and on LinkedIn.

• Scenario 1 - "Why are you treating my left shoulder?"

Scenario 1 - "Why are you treating my left shoulder?"

The clinic has had a busy few weeks and filing has got a little behind. The chiropractor is running 15 minutes late when his next patient, Mr Smith, is called in for treatment. The chiropractor glances at the notes handed to him by the receptionist and sees that Mr Smith has been having treatment for left shoulder pain for 10 weeks.

The patient is in a hurry so is keen to get on with the treatment. He tells the chiropractor that he’s feeling quite a bit better but is still getting some shoulder pain first thing in the morning. After a brief examination the chiropractor starts massaging Mr Smith’s left shoulder.

The patient looks at the chiropractor a little quizzically and the chiropractor assumes this is because the shoulder is a little stiff. However, while chatting to the patient, the practitioner realises that he has been thinking about the wrong Mr Smith.

He checks the notes and realises that the notes are for Adam Smith, but the patient is Alan Smith - who has a problem with his right shoulder.

Some questions for you to consider:

1. What is important to Alan Smith (the patient being treated) here? Why?
2. What actions should the chiropractor take, if any?
   
   You could also consider:
3. What might the chiropractor say to Mr Smith if they decide to tell him they have made a mistake? Would this be the same if Mr Smith were born and brought up in England or India or Japan?
4. Under what circumstances might they decide not to say anything to Mr Smith and move onto treating his other shoulder?
5. Are there any actions that the chiropractor might take to take to identify whether there are training needs for the receptionist or changes that need to be made with respect to how they manage the keeping and administration of records?