After an error, make the patient safe first, tell a senior colleague and report the incident through your organisation's system. Every regulated clinician has a professional duty of candour to tell the patient, apologise and explain what happens next. Saying sorry does not admit legal liability. Ask for a supportive debrief, and get help if the event keeps replaying in your mind.
Key facts
- Professional duty of candour
- Joint GMC and NMC guidance on openness and honesty when things go wrong, which other UK healthcare regulators have endorsed.
- Statutory duty in England
- CQC-registered providers must meet Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
- Scotland and Wales
- Scotland has an organisational duty of candour in force since 1 April 2018. Wales introduced a duty of candour for NHS bodies on 1 April 2023.
- Dispensing errors
- Since 2018, registered pharmacists and pharmacy technicians have a defence against prosecution for inadvertent dispensing errors in registered pharmacies, if conditions are met. A 2022 order extended the defence to hospital and other pharmacy services with a chief pharmacist.
- Apology
- An apology is not an admission of liability (Compensation Act 2006 in England and Wales, Apologies (Scotland) Act 2016).
The first hour
- Make the patient safe. Assess, treat or arrange review. For a dispensing error, contact the patient, retrieve the wrong medicine if possible and tell the prescriber.
- Tell a senior colleague or the person in charge.
- Write a factual note in the clinical record: what happened, what you did and when. Do not change earlier entries.
- Report the incident through your organisation's system. In England, NHS organisations record patient safety events on the Learn from Patient Safety Events service, often through a local system such as Datix.
Being open with the patient
The professional duty of candour applies to every regulated clinician, near misses included where the patient needs to know. Tell the patient, or the person close to the patient, what went wrong. Apologise, explain the likely effects and say what happens next. A senior colleague can join the conversation, and many organisations have a named lead for candour conversations. NHS Resolution's leaflet on saying sorry gives practical wording.
How incident reviews work now
In England, the Patient Safety Incident Response Framework (PSIRF) replaced the Serious Incident Framework. PSIRF focuses on learning about the system, such as staffing, packaging design or computer systems, rather than finding someone to blame. You may be invited to a learning response or after-action review. Ask what the review is for and who will see the findings.
An incident review is separate from any disciplinary or regulator process. If a formal investigation starts, read our investigations guide and get advice before writing a statement. Doctors and dentists contact their defence body. Pharmacists contact the PDA. Nurses contact the RCN or their union.
Writing a statement
Base a statement on the records and your memory, with times where you have them. Say what you saw, what you did and why. Describe the conditions on the shift, such as staffing and interruptions, without blaming named colleagues. Keep a copy.
Looking after yourself
Guilt, fear, poor sleep and replaying the event are common after an error. Some people describe themselves as a second victim. Ask your manager for a supportive debrief separate from the formal review. Talk to a peer support service from the list below. If intrusive thoughts, low mood or poor sleep last more than a few weeks, see your GP. If you feel unsafe, use our urgent help page.
One error rarely defines a career. Regulators look at what happened, how you responded, and what you learned. Openness and reflection count in your favour.
Support organisations
Pharmacist Support
Profession-specific support for pharmacy people, including wellbeing and practical help.
Check the provider's current criteria for pharmacists, trainees, students and family support.
BMA wellbeing services
Counselling and peer support for doctors and medical students.
The main wellbeing services have their own access rules. Additional member services may require membership.
Doctors' Support Network
Peer support for doctors and medical students with mental-health concerns.
Check membership, group arrangements and confidentiality guidance. Peer support does not replace treatment.
Doctors in Distress
Group-based support and wellbeing programmes for healthcare workers.
Programme audiences, dates and availability vary. Confirm a current programme includes your profession.
Related guides
- Patient complaints
- Worried about asking for help
- Workload and understaffing
- Supporting a colleague after an incident
Common questions
Do I have to tell a patient about a mistake?
Yes. The professional duty of candour requires you to tell the patient when something has gone wrong which has caused harm or might cause harm, apologise and explain what happens next.
Does saying sorry admit liability?
No. In England and Wales the Compensation Act 2006, and in Scotland the Apologies (Scotland) Act 2016, mean an apology is not an admission of legal liability.
Can a pharmacist be prosecuted for a dispensing error?
Registered pharmacists and pharmacy technicians have a legal defence for inadvertent dispensing errors when set conditions are met. The defence does not cover deliberate acts, and regulators can still consider fitness to practise.
Will I lose my registration for one mistake?
Rarely. Regulators consider what happened, how you responded and what you learned. Being open and reflecting on the error counts in your favour.
How do I cope after making a mistake at work?
Ask for a supportive debrief, talk to a trusted colleague or peer support service, and see your GP if poor sleep or intrusive thoughts last more than a few weeks.