The Government recently introduced the Public Office (Accountability) Bill, colloquially known as the “Hillsborough Law”, with its first reading on 16 September 2025.
It arises from the Hillsborough disaster in 1989 and also learning from the Grenfell Tower fire, the Post Office Horizon prosecutions and the infected blood inquiry. It applies to all “public authorities”, including NHS bodies and private providers of NHS care.
The Leader of the House has confirmed that Second Reading of the Bill will be taken on Monday 3 November.
Key points in the Bill:
- Duty of Candour and Assistance - A new statutory duty of candour and assistance, at inquests, inquiries and other investigations. There is an obligation to act promptly and proactively, drawing attention to relevant information and providing reasonable assistance to an inquiry or investigation, to meet its objectives. As the new duty is backed by criminal sanctions (maximum 2 years imprisonment and/or a fine), the obligations are given some “bite”, with an impact for individuals.
- Parity of Arms – Non-means tested legal aid for advice and advocacy has been extended to the bereaved family at every inquest where a public authority (e.g. an NHS body) is an Interested Person. There is a new duty for public bodies to only be represented where “necessary and proportionate” and a duty to ensure the amount spent on legal representation is proportionate.
- Misconduct in Public Office offences – The common law offence of Misconduct in Public Office would be replaced by two new statutory offences for public authorities (e.g. an NHS body), public officials (someone who works for a public authority) and “other persons with public responsibilities”:
- Seriously Improper Acts: This offense covers using a public office for personal gain or to cause detriment to another, where the person knows, or ought to have known, the action was seriously improper. Maximum penalty: 10 years' imprisonment.
- Breach of Duty to Prevent Death/Serious Injury: This offense applies to public office holders who intentionally or recklessly breach their duty to prevent death or serious injury. Maximum penalty: 14 years' imprisonment.
- Both new offenses include a ‘Reasonable Excuse’ defence, if the accused can show a reasonable excuse for their actions or inactions.
- Statutory Standards of Ethical Conduct – It will impose a statutory duty on public authorities to promote and take steps to maintain high standards of ethical conduct at all times by their staff. Ethical conduct is defined as selflessness, integrity, objectivity, accountability, openness, honesty and leadership.
The Impact on inquests
Balance & parity?
The addition of non-means tested legal aid for families is unfortunately likely to lead to longer, more complex and adversarial inquests.This is not the intention of the Bill which aims to provide greater support for bereaved families, to enable them to participate fully and effectively in inquests, inquiries and other investigations where the state is involved, ensuring more balance and parity between parties.
It is currently unclear how the expansion of non-means test legal aid will operate; it may cause delays and cost limits will presumably be imposed. An inquest is an inquisitorial, not adversarial, process. However, inquests can still feel adversarial, and it appears likely that the Bill will result in a substantial increase in the instruction of lawyers for families and, in response, for public authorities.
Who will pay the costs?
Currently, legal aid for representation at an inquest is granted in exceptional circumstances, primarily under two grounds:
- Article 2 of the ECHR: This is the most common basis for legal aid, where the death involved a state or public body. Examples include deaths in police custody, prisons, or due to state failings in care.
- Wider Public Interest Determination: The Legal Aid Agency can grant funding if it believes that providing legal support to the bereaved family will result in significant benefits for the wider public.
A family’s inquest costs are currently potentially recoverable from the Defendant where there is a successful claim and attendance at the inquest was relevant to the subsequent proceedings, especially where relevant admissions of liability had not been made ahead of the hearing. Inquest costs are still subject to the test of proportionality.
The changes proposed by the Bill are expected to significantly increase the number of occasions when families have legal representation at an inquest, which will significantly increase the cost of inquests to the public purse. It is anticipated that there will be:
- A direct impact - such as when a claim (including for a family’s legal costs) follows an inquest, or where a public body feels it is necessary and proportionate to obtain legal support in response to a family’s instruction of lawyers.The impact is particularly significant because claimants’ solicitors’ hourly rates are far higher than those of lawyers acting for public bodies and their litigation costs are often many times higher.
- An indirect impact - The economic impact assessment of the Bill indicates that this change is likely to cost between £65m - £108m per annum and the current policy intention is that these costs will be met by the sponsoring department for the relevant public authority. It is therefore anticipated that where an NHS trust is an Interested Person and a family receive legal aid funded representation, the costs will ultimately be picked up by the NHS (e.g. via the budget of the Department of Health and Social Care).
Planning and Tactical considerations
- Staff training and updates to policies will be necessary, to ensure that everyone is clear regarding their enhanced obligations in relation to candour and assistance, both for the organisation and as an individual. Staff should be clear regarding their ethical responsibilities and the statutory offences.
- There will need to be an increased scrutiny of the information / evidence/ disclosure for an inquest, given the enhanced duty to assist the Coroner, ensuring proactive and transparent engagement throughout the inquest process.
- Internal investigations are likely to face increased scrutiny, at the time and subsequently, with regard to what information was volunteered/provided and when.
- The increased use of representation by families, and the resulting risk of costs, might increase the need to obtain expert evidence before inquests. See - Are expert reports in inquests privileged and protected from disclosure? | Weightmans
- Early and candid conversations with families, as expected in the NHS as part of the PSIRF process, could help to reduce the risks of an adversarial inquest.
- We will have to wait and see how the elements in the Bill are enforced in practice.
Timeframes
The Leader of the House has confirmed that Second Reading of the Bill will be taken on Monday 3 November. The Bill has several stages to pass through before it becomes law. We estimate it will not likely become law before Spring 2027.
The existing CQC Regulation 20 duty of candour, under the Health and Social Care Act 2008, and other governance
The duty of candour is an existing requirement for all healthcare organisations and professionals designed to improve patient outcomes by imposing an obligation to be open and honest with patients when things go wrong. It has two main forms:
- Professional duty of candour - The professional duty of candour applies to regulated healthcare professionals and is overseen by their respective regulators. It is triggered when something goes wrong in patient care, causing harm or distress. This threshold is relatively broad, including incidents causing any level of harm or distress.
- Organisational duty of candour - The organisational duty of candour is codified in regulations and applies to healthcare providers, including NHS bodies. It is categorised into the:
- General Duty: A broader obligation not restricted to specific incidents.
- Specific Duty: Requires organisations to notify patients or their families about notifiable ‘safety incidents causing death, severe harm, moderate harm, or prolonged psychological harm. Non-compliance constitutes a criminal offense.
Statutory duty of candour
The statutory duty of candour was introduced in 2014, building upon existing contractual obligations. Initial discussions emphasised transparency and patient communication, to foster trust and learning from adverse events. However, a decade later, issues persist, including inconsistent application, cultural resistance, and inadequate training. High-profile cases, such as those involving disciplinary investigations or systemic failures, highlight the complexity of applying the duty. See - Broken trust: making patient safety more than just a promise 2023 PHSO.
The Government’s 2024 manifesto
The Government pledged to introduce a ‘Hillsborough Law’ placing the legal duty of candour on both public servants and authorities and providing legal aid for victims of disasters or state-related deaths. As its name suggests, the inspiration behind the pledge was the tragic events (and subsequent scandal) of the Hillsborough disaster. See - The new duty of candour: will it apply to me? | Weightmans
DHSC call for evidence
The DHSC launched a call for evidence on the statutory duty of candour for health and social care providers in England in April 2024 (Duty of candour review - GOV.UK). This call for evidence formed part of a wider review of the duty, which was announced by the government in response to the Hillsborough disaster report.
Proposals to regulate NHS managers
In 2024, the Department of Health and Social Care launched a consultation exploring the regulation of NHS managers under the duty of candour. This initiative aimed to address gaps in accountability and ensure that managers adhere to professional standards. See - Spotlight on duty of candour and regulating NHS managers | Weightmans. The consultation outcome was updated in July 2025 (Leading the NHS: proposals to regulate NHS managers consultation response - GOV.UK) confirming that “the consultation demonstrated that there is appetite to go further in extending the scope of regulation to more parts of the system (including primary care and the private sector), and to include further levels of management (for managers in NHS Agenda for Change pay scales bands 8d and above). As such, we are committing to keep this policy under review to ensure that it continues to best serve the interests of patients and the public, recognising the novel and transformational impact that a future regulatory regime will have across the NHS and beyond”.
Cultural and leadership considerations
Effective implementation of the duty of candour hinges on fostering a positive organisational culture. Key initiatives include:
- Psychological Safety: Encouraging staff to report incidents without fear of retribution.
- Freedom to Speak Up Guardians: Providing channels for raising concerns and ensuring organisational accountability.
- Leadership Accountability: Emphasising the role of senior managers in setting the tone for openness and continuous improvement.
Many inquiries have spotlighted the impact of leadership on organisational culture. Defensive or punitive environments undermine the principles of candour, whereas positive leadership can enhance staff morale, patient safety, and overall trust in healthcare systems.
Regulation alone cannot achieve the desired outcomes. Comprehensive training, clear communication channels, and a supportive culture are equally critical. Healthcare organisations must balance regulatory compliance with creating an environment where candour is not just a legal obligation but a shared value. By doing so, they can ensure that patient safety remains at the heart of their mission, fostering trust and accountability across the sector.
