NMC Professional Duty of Candour 3 — Questions and Answers
Question 1: Which of the following BEST distinguishes the professional duty of candour from the statutory duty of candour?
- The professional duty applies only to senior nurses; the statutory duty applies to all staff
- The professional duty applies to individual registrants; the statutory duty applies to healthcare organizations (Correct answer)
- The statutory duty is voluntary; the professional duty is legally enforced
- There is no practical difference between the two duties
Correct answer: The professional duty applies to individual registrants; the statutory duty applies to healthcare organizations
The professional duty of candour applies to individual NMC registrants, while the statutory duty (under the Health and Social Care Act) applies to the organization as a whole.
Question 2: A nurse is pressured by a manager not to disclose an error to a patient because the organization fears legal action. What should the nurse do?
- Follow the manager's instruction to protect the organization
- Comply but document the manager's instruction privately
- Maintain their professional duty of candour and disclose, escalating the pressure as a concern (Correct answer)
- Seek the patient's next of kin's consent before disclosing
Correct answer: Maintain their professional duty of candour and disclose, escalating the pressure as a concern
A nurse's professional duty of candour cannot be overridden by managerial pressure; they must disclose and raise the suppression as a safeguarding concern.
Question 3: After a notifiable safety incident, the NMC requires that an apology and explanation be provided:
- Only in writing, via the hospital's formal letter process
- Verbally as soon as practicable, followed by a written summary (Correct answer)
- Only after the patient or family requests an explanation
- Exclusively through the hospital's Patient Liaison Service
Correct answer: Verbally as soon as practicable, followed by a written summary
The NMC duty of candour requires an initial verbal apology and explanation as soon as possible, followed by a written summary.
Question 4: A nurse notices a colleague made an error that harmed a patient but the colleague has not disclosed it. The observing nurse should:
- Stay silent to respect colleague confidentiality
- Encourage the colleague to disclose and, if not, raise the concern themselves (Correct answer)
- Report directly to the patient without telling the colleague
- Wait until the incident review meeting to mention it
Correct answer: Encourage the colleague to disclose and, if not, raise the concern themselves
Nurses have a responsibility to support colleagues in fulfilling candour obligations and to escalate if a colleague fails to disclose a patient safety incident.
Question 5: Which patient group requires SPECIAL consideration when fulfilling the duty of candour according to NMC guidance?
- Patients who are privately funded
- Patients who lack capacity to understand the disclosure (Correct answer)
- Patients admitted through the emergency department
- Patients who have previously filed complaints
Correct answer: Patients who lack capacity to understand the disclosure
When a patient lacks capacity, disclosure should be made to their representative or next of kin, adapting communication to meet the patient's needs.
Question 6: Which of the following is a known BARRIER to fulfilling the duty of candour that the NMC acknowledges?
- Lack of a standardized apology template
- Fear of disciplinary action, blame culture, or litigation concerns (Correct answer)
- Insufficient time allocated in training programs
- Patients refusing to hear about errors
Correct answer: Fear of disciplinary action, blame culture, or litigation concerns
The NMC recognizes that blame culture, fear of punishment, and litigation concerns are significant barriers that prevent open disclosure.
Question 7: Under the duty of candour, what information must be shared with the patient following a safety incident?
- Only the clinical outcome, not the cause of the incident
- The facts known about the incident, an apology, and what is being done to prevent recurrence (Correct answer)
- The names of staff involved, for full transparency
- Only information that does not risk further distress to the patient
Correct answer: The facts known about the incident, an apology, and what is being done to prevent recurrence
Patients are entitled to know what happened, to receive an apology, and to hear what steps are being taken to prevent the same incident from recurring.
NMC Professional Duty of Candour 3
Which of the following BEST distinguishes the professional duty of candour from the statutory duty of candour?