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Duty of candour: BMJ investigation reveals patchy enforcement by regulatory agencies

BMJ 2024; 385 doi: (Published 08 May 2024) Cite this as: BMJ 2024;385:q993

Linked Opinion

David Oliver: How well is the duty of candour enforced in the NHS?

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Re: Duty of candour: BMJ investigation reveals patchy enforcement by regulatory agencies

Dear Editor,

Candour, and transparency were frequently discussed at the WHO Patient Safety Conference in Geneva which a few hundred patients and professionals attended in September last year. Patients' inclusion in the governance and safety care pathways was a primary topic at the conference. Patients wished to be involved with medical care pathways throughout their treatments. Patients wished to be engaged in health care pathway governance without obstructing or hindering care pathways.

The conference discussed and shaped a first WHO Patient Safety Charter which was published on April 16th this year.[1]

The charter includes 10 patient rights. Patient Right No 8 is the right for patients to access medical records. This will increase candour as patients and allotted proxies are able to follow care pathways more closely.

" 8. Right to access to medical records. Patients have the right to access or obtain a copy of their records in a usable and an understandable format. This includes both physical and electronic records that are accurate and up to date. Patients are entitled to request corrections to factual inaccuracies and control the use of their information. A patient may designate a representative to access or obtain their records. Patients also have the right to easily transfer their medical records when seeking second opinions or changing health care facilities."

Record access is not primarily for candour, it is to prevent and avoid medical accidents. We have plenty of examples of patients highlighting issues of service provision that could be improved with access to their medical records.


Competing interests: No competing interests

16 May 2024
Richard P Fitton
Retired GP