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Candour, disclosure and openness

Learning from academic research to support advice to the Secretary of State

This research supports our advice to the Secretary of State for Health on how professional regulation can encourage health professionals and social workers to be more candid when things have gone wrong. The main report containing our advice can be found at

In order to understand the limits and potential for regulatory action in this area, we have explored literature from around the world on the topics of disclosure, whistleblowing, patient safety, adverse events, medical ethics, regulation, and the behavioural sciences. This is not however a comprehensive, formal academic literature review. We have looked for a sample of literature relevant to this specific issue across a number of academic disciplines over a relatively short period of time. In the longer term, we are working to compile a catalogue of academic and other literature which is relevant to different aspects of professional regulation, and can be found on our website here: We would be pleased to receive feedback on further literature not referenced here or on our website which is relevant to candour and disclosure, or to professional regulation more generally.

The bulk of the relevant literature concerns doctors; other than a handful of studies on nurses, we found little that related to other healthcare professions or social work. We have therefore made clear where findings may be specific to a profession or professional context. Most of the research originates from the US and Australia. We have highlighted any findings or conclusions we believe may not be applicable to the UK context.

We have used the term ‘candour’ to describe both whistleblowing, which we take to refer to the reporting of concerns about care provided by others, and disclosure, which refers here to the reporting of one’s own mistakes. This is broader than the terms used in the commission that triggered this research and in our subsequent advice to the Secretary of State. However, we felt it was important for us to consider the full scope of relevant literature.