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  4. Duty of candour in practice

Duty of candour in practice

How we’re working with organisations across the UK to ensure that the duty of candour is implemented effectively.

2014: A turning point

After campaigning for more than 20 years for the introduction of a statutory duty of candour for UK healthcare organisations, Avma was delighted to see the implementation of legislation in England in 2014 giving patients and their families this critical element of safety and care.

However, progress has been slow in other parts of the UK. We continue to work with partners and regulators in England, Wales, Scotland, and Northern Ireland to ensure that the duty of candour is implemented effectively. Read about progress in each of these regions below.

The duty of candour in England

In England, the duty of candour is enshrined in law by Regulation 20 of the Health and Social Care Act 2008. The duty applies to all healthcare organisations registered with the Care Quality Commission (CQC). You can read the full contents of Regulation 20 on the CQC website.

Avma continues to work with the CQC and the Department of Health and Social Care (DHSC) to ensure that the duty of candour is implemented as effectively as possible. In October 2018, we made several recommendations about how the duty is regulated in England.

The duty of candour in Scotland

The duty of candour came into force in Scotland in 2018, enforced in the Duty of Candour Procedure (Scotland) Regulations 2018.

Avma works closely with its partners in Scotland to ensure that law firms, healthcare providers, and the public understand the duty of candour.

The duty of candour in Wales

Almost ten years after its implementation in England, the duty of candour became a legal requirement for all NHS organisations in Wales in 2023. Read more about the duty of candour in Wales on the Welsh Government website.

Avma consistently called for a statutory duty of candour in Wales, but it took many years to implement. Prior to the new legislation, we provided advice on appropriate guidance for implementation of the duty of candour in Wales.

The duty of candour in Northern Ireland

As of June 2026, Northern Ireland remains the only country in the UK which has not yet implemented the duty of candour in law. Avma continues to call for implementation of the duty, with our involvement stretching back over ten years to meetings between our former CEO Peter Walsh and then-Health Minister Edwin Poots.

From late 2024 to early 2025, the Department of Health in Northern Ireland held a public consultation regarding the establishment of a duty of candour in the country. This has not yet led to implementation of a duty for all healthcare organisations, however it is anticipated that this will happen soon.