BBK Manifesto 2026: The NHS needs a renewed commitment to candour

Openness, honesty and accountability should be the foundations of every healthcare system. Yet taking the findings of the recent Ockenden and Amos maternity reviews as recent examples, it’s clear that, despite a legal duty of candour being in place for more than a decade, too many families are still being denied the truth when things go wrong.  

The issue has come into sharp focus following Donna Ockenden’s review into maternity services at Nottingham University Hospitals NHS Trust. During the review, around half of the senior leaders invited to participate chose not to engage. For bereaved and traumatised families who have spent years seeking answers, this was a stark and painful reminder that transparency and accountability are still too often treated as optional.  

At its heart, candour is about more than compliance with a legal requirement; it is about creating a culture where healthcare professionals are encouraged to speak openly and without fear of recrimination, where concerns are actively listened to, and where mistakes are acknowledged and learned from. Families should never have to fight for the truth after experiencing harm or loss, and staff should never fear professional consequences for raising safety concerns. 

That’s why BBK’s Manifesto for Injured People proposes a renewed national commitment to candour across the NHS. 

Families still ignored 12 years after the Francis report

The NHS was meant to embrace a statutory duty of candour in 2014 following the Francis report into the Stafford Hospital scandal, which exposed widespread patient neglect and a toxic culture that ignored patient suffering. The duty of candour requires organisations to be open and honest when incidents cause significant harm. Yet disappointingly the recurring themes emerging from the numerous maternity scandals across England suggest that embedding this duty in day-to-day practice remains a significant challenge to this day. Time and again, investigations have found that families felt ignored, concerns were dismissed, warning signs were missed and opportunities to learn and improve standards of patient care were lost.  

The Amos review highlighted the importance of tackling cultures of fear, where speaking up is discouraged and accountability is lacking. Staff working under intense pressure, with workforce shortages and high levels of burnout, may be less likely to raise concerns if they believe nothing will change or if they fear repercussions. When this happens, unsafe practices can become normalised and opportunities to prevent harm are missed.  

Culture matters. Policies and regulations alone cannot deliver change unless they are supported by leadership that actively promotes openness, learning and psychological safety. We know from countless investigations that poor culture is often at the root of healthcare failures. Equally, organisations that embrace transparency are more likely to identify risks early, learn from mistakes and improve patient outcomes. 

Ensuring candour makes a real difference

The proposed Public Office (Accountability) Bill, commonly known as the Hillsborough Law, could mark a significant step forward. By creating a stronger duty of candour for public officials involved in investigations and inquiries, it has the potential to ensure greater transparency and accountability when public services fail. Plus it means there will be criminal sanctions for failure to comply. 

But more must be done. 

The NHS needs a refreshed national focus on candour. Not simply as a regulatory requirement, but as a core value that shapes behaviour at every level of the organisation. 

We are calling for: 

• A renewed national commitment to the duty of candour, with clear expectations for all NHS leaders and organisations. 

• Stronger protections for whistleblowers, ensuring staff can raise concerns without fear of recrimination. 

• Greater accountability for senior leaders who fail to engage with investigations or act on safety concerns. 

• Better support for affected families, including timely access to information, explanations and involvement in investigations. 

• Routine measurement of organisational culture, with transparency about how NHS trusts are performing on speaking up, learning and patient engagement. 

If the NHS is serious about preventing future harm, candour cannot remain an aspiration. It must become the norm. Families deserve honesty, staff deserve to be heard, and patients deserve a healthcare system that learns from its mistakes instead of hiding them. The time for a renewed commitment to candour is now. 

This blog is part of our 2026/27 Manifesto for Injured People. At Bolt Burdon Kemp, we support injured people not only by winning their cases but by driving positive change. Guided by our clients’ experiences and partnerships with charities across the UK, we are raising awareness of the changes needed to better support injured people. We will continue working with politicians from all parties to ensure injured people’s needs are not overlooked in Westminster or beyond. You can read our full manifesto here.