Duty of candour in a dental practice

The duty of candour in a dental practice means being open and honest with patients about their care, and following a set legal procedure when a serious incident happens. Regulation 20 requires the practice to tell the patient in person, apologise, explain what is known, and follow up in writing.

This article covers England, where CQC regulates the statutory duty. It is general information. Whether a particular incident meets the legal threshold needs the judgement of a healthcare professional, and your indemnity provider or a solicitor can advise on a specific case.

Two duties, side by side

There are two types of duty of candour, and they apply to different people.

	Statutory duty	Professional duty
Applies to	The registered provider and registered manager	All registered dental professionals, as individuals
Overseen by	CQC	General Dental Council (GDC)
Triggered by	A general duty to be open, plus set steps for a notifiable safety incident	Something going wrong that causes, or could cause, harm or distress

CQC is clear that, for a notifiable safety incident, carrying out the professional duty alone will not be enough to meet the statutory one.

What counts as a notifiable safety incident

CQC says an incident must meet all three of these criteria:

It was unintended or unexpected.
It happened during the provision of an activity CQC regulates.
In the reasonable opinion of a healthcare professional, it reached the harm threshold.

A dental practice that is not a health service body, such as an NHS trust or foundation trust, uses the thresholds in paragraph 9 of the regulation. The incident must appear to have resulted in one of the following, or require treatment by a healthcare professional to prevent the person’s death or an injury that would lead to one of them:

the person’s death, where it relates directly to the incident
an impairment of sensory, motor or intellectual functions that has lasted, or is likely to last, at least 28 days
changes to the structure of the person’s body
prolonged pain or prolonged psychological harm, meaning at least 28 continuous days
a shortening of the person’s life expectancy

Fault makes no difference to whether something is a notifiable safety incident, and neither does the patient having given consent. Near misses are not intended to be in scope. Even where an incident falls short, the general duty to be open and transparent still applies.

A dental example from CQC

CQC’s worked examples include one from a dental practice. A child with an unknown latex allergy attended a check-up, the dentist wore latex gloves, and the child had a very severe anaphylactic reaction which required hospitalisation. The child made a full recovery.

CQC concludes this is a notifiable safety incident because the child needed further treatment to prevent death. It notes there was no suggestion of fault, and that none is needed.

What you must do

Once you know a notifiable safety incident has happened, Regulation 20 sets out these steps, to begin as soon as reasonably practicable:

Tell the relevant person in person. This is the patient or, in some circumstances, someone lawfully acting for them, such as when the patient has died, or is a child who is not competent to decide.
Give a true account of all the facts you know at that date.
Explain what further enquiries you believe are appropriate.
Apologise. The regulation defines this as an expression of sorrow or regret.
Record it in a written record that is kept securely.
Follow up in writing with the same information, details of the enquiries, their results, and an apology.
Give reasonable support throughout, and keep a copy of all correspondence.

If the person cannot be contacted or declines to speak to you, the steps above do not apply, but you must keep a written record of your attempts.

CQC gives examples of reasonable support, including an interpreter, information in accessible formats, and signposting to independent help.

Saying sorry

Fear of admitting liability is the usual reason people hesitate. CQC states plainly that apologising is not an admission of liability, and the GDC says saying sorry is not the same as admitting liability.

What a dental nurse must do

The legal procedure in Regulation 20 falls on the registered provider or manager, who can delegate carrying it out. A dental nurse has the professional duty, because the GDC’s guidance applies to all registered dental professionals as individuals.

Under that guidance, when something goes wrong with a patient’s care, a registered professional must tell the patient, apologise, offer an appropriate remedy or support to put matters right if possible, and explain the short and long term effects. The GDC also expects professionals to be open and honest with colleagues and employers and to raise concerns, even if nothing has gone wrong.

In day-to-day terms, a nurse who sees something go wrong needs to know who to tell in the practice, and that they will be supported for doing so. It helps to put that in the policy and go through it as a team.

What CQC looks for

CQC says it may ask providers about recent incidents and question frontline staff about their understanding of the duty, and the registered person about policies, records and training. It can take enforcement action, and Regulation 20 allows it to move directly to criminal enforcement.

Some incidents also have to be notified to CQC, which is a separate duty. See our notes on Regulation 20 and recording significant events.

Compliance UK’s incidents and complaints records let you log incidents as they happen, and each record shows its statutory clock to the manager.

Sources

Sources checked on 10 November 2026.

Duty of candour in a dental practice: what you must do