Organisational Duty of Candour: non-statutory guidance - revised March 2025

7. Notification

Every relevant person must be notified about the activation of the procedure as soon as reasonably practicable. It is good practice, as per the National Framework for Scotland^[23], to notify a relevant person within 10 working days of the procedure start date.

When it is identified that there are multiple relevant persons, they should be notified about the activation of the procedure at the same time. It may take time to identify all the people who have potentially been affected and it is common in multiple patient incidents for some time to have passed before the incident is identified and all relevant persons identified. Some relevant persons may not be aware they have been involved in the incident, and the first they become aware of it is when they are notified by the organisation. Informing everyone who may have been harmed at the same time reduces the risk of speculation and distress resulting from rumours or speculation.

If another relevant person is identified following the conclusion of the review, they must be notified, and the organisational duty of candour procedure must be activated again, providing relevant persons identified with information about why the procedure was activated when it was (and in particular the decision not to activate the procedure prior to a process of reviewing events and outcomes) and given the opportunity to fully engage in the process. Responsible persons will also need to consider any action required to consider issues raised by such relevant persons if they have not been considered as part of the previous review.

This notification can be by various methods including telephone, face to face, online via email or video call, or by letter. It is important to remember that where an organisational duty of candour procedure start date is more than a month after the incident occurred, the organisation must explain to the relevant person the reason for this.

Things to consider:

Before notifying the relevant person, the organisation should consider:

• who from the organisation is already in contact with the relevant person
• what discussions or information exchange has already taken place
• what is the relevant person’s current understanding of the incident and organisational response to this?
• has all background information about the incident been sent to the relevant person? This should include:
• summary of the incident
• a list of any actions taken by the organisation up to that point
• the relevant person should be advised of any public-facing communication relating to the incident, such as media reporting and/or press releases – a copy of any material or information issued should be shared with them
• whether the relevant person requires time to process the situation and prepare before a full conversation takes place
• where the conversation takes place
• who should be part of it, and who should lead that conversation
• what support should be available to the relevant person, during the conversation and afterwards
• who will be the single point of contact following the discussion with the relevant person
• the notification must include:
• an account of the incident to the extent that the organisation is aware of the facts at the date the notification is provided
• an explanation of the actions that the organisation will take as part of the procedure
• where the procedure start date is later than one month after the date on which the incident occurred, an explanation of the reason for this
• In cases where the procedure start date is later than one month after the date of the incident, an explanation of the reason for the delay in starting the procedure must be provided.

The information that an organisation may need to consider when activating the organisational duty of candour procedure can come from a range of sources. It is important that organisations identify what these sources are and ensure relevant information, support and co-ordination mechanisms are in place. In some instances, organisations may be contacted by other organisations providing health, care or social work services prior to the activation of the organisational duty of candour procedure. Organisations should ensure that staff are aware of how to deal with such situations.

Feedback to organisations has highlighted that people attending meetings may not always have sufficient awareness of the organisational duty of candour, nor the process that will be followed. Organisations should provide the relevant person with information on the organisational duty of candour process and what they can expect.

Leaflets are available on the Scottish Government’s website: Duty of Candour: leaflets (www.gov.scot)^[24] and cover the following issues:

• what happens when things go wrong – provides information about when Duty of Candour should be activated, what the relevant person should expect, and what happens during the procedure
• what it means to you – to be given to patient, service user, or person acting on their behalf

Organisations should make the relevant person aware that they are able to attend these meetings with a person to support them if they wish, and, with the permission of the relevant person, organisations could offer to provide information on the activation of the organisational duty of candour to family members. Providing information on the organisational duty of candour and the process can help reassure and prepare families for the process ahead and what that means for them.

Organisations should consider the individual support needs of the relevant person throughout the organisational duty of candour procedure.

Once it is established that the organisational duty of candour is going to be activated, staff who were involved in the incident should have a single point of contact for the review, who will inform the staff member that a review will take place. This could be the same individual who has been identified as the single point of contact for the relevant person. It is important for staff to understand the process from the onset of the review and any information about the process is provided in a sensitive, supportive and compassionate manner.

Hearing that there is to be a review can be distressing for staff involved. Organisations should bear in mind that fear of the unknown can add to the negative impact. The organisation should be aware of the potential psychological impact and distress staff could be experiencing after an adverse event. More information on training and support for staff can be found at section 4 above.