When things go wrong: candour, apology, incident communication, and speaking up

Sometimes difficult conversations follow an error or when a team member suspects something important has been missed. Safe pharmacy practice relies on openness, accurate records, timely escalation, and a workplace where people can raise concerns.

Being open and honest when things go wrong

If an incident affects a patient they may need a clear explanation, an apology, and prompt advice about next steps. An apology recognises the impact on the patient and signals a professional, transparent response; it does not automatically assign individual blame for system failures or colleagues' actions.

Follow any relevant local policy or legal requirements. Some settings have a statutory duty of candour; in all settings pharmacy professionals must be open, honest, and put patient safety first.

Nation-specific note: in Scotland, there is an organisational duty of candour procedure backed by legislation and revised March 2025 guidance for organisations providing health, care, and social work services. In Northern Ireland, the Department of Health launched the Being Open Framework for Health and Social Care on 19 February 2026, with implementation beginning on 1 April 2026, and is progressing organisational duty of candour legislation. Pharmacy teams in Scotland and Northern Ireland should therefore check the local organisational framework, reporting route, and employer policy rather than relying only on England-facing candour material.

Key principles

• Act promptly: delay increases confusion, mistrust and the chance of further harm.
• Say what is known and what is not known: do not guess or hide uncertainty.
• Apologise appropriately: a sincere apology and a clear explanation are part of professional practice.
• Record accurately: document what happened, what was said, what advice was given and what follow-up was arranged.
• Escalate concerns about missed issues: if you think a colleague may have overlooked something important, raise it promptly and privately via the correct route.

After the conversation: follow-up, documentation, and team support

The initial conversation is the start of the response. Proper follow-up reduces confusion, supports safer care and helps the team learn and recover.

• Record the essentials: note what was explained, who led the conversation, what questions were asked and what next-step advice was given.
• Document safety-netting clearly: record any distress, refusal, urgent referral, non-supply, incident follow-up or advice about what to do if the situation worsens.
• Do not leave the person stranded: ensure the patient is not left at the counter, on the phone or at handout without knowing what happens next.
• Hand over internally: if a colleague must call back, provide written information, complete referral support or manage follow-up, make the handover deliberate and clear.
• Use local incident and candour processes where relevant: events linked to errors, harm or possible harm may need escalation under local reporting, investigation and candour procedures.
• Debrief briefly afterwards: a short team check-in can confirm facts, identify immediate learning and reduce the risk of mixed messages or unfinished tasks.
• Support staff wellbeing: emotionally charged conversations can affect staff. Know when to pause, seek support and use local wellbeing or supervisory routes. NHS England's handling difficult situations with compassion training also emphasises looking after yourself if you are affected.

Speaking up about a possible missed concern

Raising a concern about a colleague can feel difficult, particularly with senior staff. Patient safety overrides hierarchy or embarrassment. Use factual, respectful language, pick an appropriate moment if the issue is not urgent, and follow local escalation processes. If the risk is immediate, act immediately.

Openness, apology, accurate records and early escalation are not optional extras. They are integral to safe pharmacy care and to maintaining trust when something has gone wrong.