What an NHS lookback review means for you

At a glance

• The NHS duty of candour requires healthcare providers to be open and transparent when certain patient safety incidents occur.
• An NHS lookback review examines past patient care after concerns are identified about a service, treatment, practitioner or group of patients.
• You can request access to personal information held in your NHS medical records, usually free of charge.
• You can make an NHS complaint and pursue a clinical negligence claim separately. You don’t necessarily have to choose between them.

Opening a letter from the NHS stating your past medical treatment is part of an official review can feel deeply unsettling. It’s entirely natural to feel anxious or confused about why your care is being scrutinised months or even years down the line.

This guide breaks down what an NHS lookback review actually involves, how the NHS duty of candour protects your rights to total transparency, and what practical steps you can take to safeguard your health and your legal position.

What is the NHS duty of candour?

The statutory NHS duty of candour under Regulation 20 of the Health and Social Care Act 2008 requires healthcare organisations to act with openness and transparency when things go wrong. It obliges NHS trusts to inform you promptly if you’ve been involved in a notifiable safety incident, provide a truthful account of events, give a formal apology, and explain any ongoing investigation. This requirement ensures that hospitals can’t hide mistakes or delay disclosures.

It’s important to understand the difference between the statutory and professional duty of candour:

• Statutory duty: Applies to the NHS trust as an organisation under CQC regulation.
• Professional duty: Owed by individual healthcare workers to their regulatory bodies, such as the General Medical Council (GMC) or Nursing and Midwifery Council (NMC).

Under General Medical Council guidance, individual doctors must be honest with you immediately when harm occurs, regardless of internal hospital processes.

A Notifiable Safety Incident (NSI) is an unintended or unexpected event during care that leads to moderate harm, severe harm, prolonged psychological harm, or death. Moderate harm includes injuries requiring extra treatment, such as an unintended secondary surgery or permanent minor damage. This formal transparency standard stems from landmark patient safety campaigns, including the Francis Inquiry into Mid Staffordshire NHS Foundation Trust and the case of Robbie Powell, whose family fought for mandatory honesty in healthcare.

Why do NHS trusts run lookback reviews?

An NHS lookback review occurs when a hospital checks past clinical records to ensure previous care met safety standards. Receiving a lookback notification doesn’t automatically mean that you suffered harm or that your care was negligent. In many cases, trusts audit broad historical patient cohorts simply out of an abundance of caution after discovering a potential flaw in their systems.

Here are a few common reasons NHS trusts initiate historical reviews:

• Systemic clinical errors: Identifying a pattern of diagnostic delays, faulty test interpretation, or incorrect treatment protocols across a specific department.
• Individual practitioner investigations: Concerns raised about a single surgeon, doctor, or radiologist, triggering a review of all patients treated by that professional.
• Equipment or medicine recalls: Failures linked to specific medical devices, implants, or batch manufacturing issues used during surgical procedures.
• Internal and external audits: Regular quality assurance checks or Care Quality Commission (CQC) inspections uncovering historic gaps in record-keeping or care standards.

When a trust initiates a review, you’ll typically receive a formal letter outlining why your case is included. The letter should explain the scope of the investigation, provide a dedicated point of contact, and set out the expected timeline for findings. While waiting for answers can feel frustrating, these proactive reviews are designed to uphold patient safety and reveal the truth.

How to request your NHS medical records

Obtaining your complete medical history is a vital step when an NHS review of your care becomes a concern. Having your full notes allows you to verify the accuracy of the hospital’s review and seek independent advice.

1. Identify the correct data protection department: Contact the Subject Access Request (SAR) team or Access to Health Records department at the specific NHS trust that provided your care.
2. Submit a formal written request: State clearly that you’re making a Subject Access Request under the Data Protection Act 2018. Specify the exact records you need, including operation notes, diagnostic scans, nursing charts, and internal correspondence.
3. Provide proof of identity: Supply copies of requested identification documents, such as a passport or driving licence, alongside a recent utility bill to verify your address.
4. Review your notes upon receipt: Check through the documentation carefully once received, noting any missing dates, redacted sections, or entries relating to the review.

Under data protection legislation, submitting a request for your medical records is completely free of charge. The NHS trust must supply your records within one calendar month. If your record request is complex or involves extensive historical data, the trust may extend this deadline by up to two additional months, but they must inform you of the delay within the initial 30 days.

Should I complain, make a claim, or both?

When a hospital review discloses potential care failures, deciding how to respond can feel confusing. You don’t have to choose between raising a formal complaint and pursuing a medical negligence claim. These are distinct processes with different goals, and you can pursue both at the same time.

If you want a straightforward explanation of what went wrong, contacting the Patient Advice and Liaison Service (PALS) or lodging a formal NHS complaint is often the fastest route. PALS provides confidential support and helps navigate the internal healthcare system.

We understand you might worry that taking action will compromise your ongoing care. Healthcare professionals are bound by legal and ethical duties to provide equal treatment to every patient. Making a complaint or seeking legal guidance will never affect the quality of care you receive.

Do I need a solicitor for an NHS lookback review?

You don’t need a solicitor simply to participate in an NHS lookback review or to receive a duty of candour disclosure letter. The trust is legally required to conduct its investigation and share its findings with you directly, regardless of whether you have legal representation.

However, seeking independent legal advice becomes valuable if the review reveals that you suffered avoidable harm, or if you feel the hospital’s internal report leaves critical questions unanswered. Interpreting complex medical reports can be difficult, and specialist solicitors help clarify whether care fell below acceptable standards.

Working with a no win, no fee solicitor means you can explore your legal position without financial risk. If we investigate your case and find evidence of medical negligence, we handle the claims process on your behalf, ensuring your rights are fully protected while you focus on your health.

Who can help if an NHS lookback review raises concerns about your care?

An NHS lookback review may identify concerns with treatment you received months or even years ago. If the review relates to breast cancer care and you’re worried you may have experienced avoidable harm, you can speak to Tanzeela and her all-female team.

They understand how unsettling it can be to have questions raised about previous medical treatment. From your first conversation, they’ll listen to your experience, explain your options clearly and help you decide what steps you may want to take next.

Understanding medical negligence time limits

Managing legal timelines is essential if a review shows you received substandard care. The law sets strict deadlines for bringing a clinical negligence claim in England and Wales.

• Standard three-year limitation: You generally have three years from the date the negligent treatment occurred to start court proceedings.
• Date of knowledge exception: If harm wasn’t immediately obvious, the three-year clock starts from the date you first realised (or should have realised) that your injury was linked to substandard care.
• Children’s claims: For children, the three-year time limit doesn’t begin until their 18th birthday, meaning they have until age 21 to make a claim.
• Mental capacity exceptions: If a person lacks the mental capacity to manage their own legal affairs, the three-year limitation period is paused indefinitely unless capacity is regained.

Determining the exact limitation date for historical care can be legally complex, particularly for treatment received years ago. Because strict deadlines apply, seeking legal advice early ensures you don’t lose your right to pursue answers.

What are your next steps?

Receiving contact regarding an NHS lookback review can feel overwhelming, but remember that the duty of candour exists to protect your right to truth and transparency. You’re entitled to clear answers, full access to your medical records, and appropriate support. Whether you choose to lodge a formal complaint, seek independent legal advice, or simply request your notes, you don’t have to navigate the process alone.

If you have questions about care failures or want clear advice on your rights, our friendly team is here to listen and help. Contact us today to learn more about medical negligence and how we can support your journey.

NHS duty of candour and lookback review FAQs

What is a notifiable safety incident under the duty of candour?

A notifiable safety incident is an unintended event during NHS treatment that caused or could cause moderate harm, severe harm, permanent harm, or death. It legally obliges the healthcare trust to inform you, explain what happened, and provide a formal apology.

Does an apology from the NHS count as an admission of legal liability?

No. Under NHS Resolution guidance and Section 2 of the Compensation Act 2006, a formal apology or explanation isn’t an admission of legal liability. It’s simply a step towards mandatory openness and transparency under the statutory duty of candour.

Will making a claim affect my future NHS treatment?

No, it won’t. NHS staff are bound by professional codes of conduct to treat all patients equally. Making a complaint or bringing a legal claim will never compromise the quality or availability of your ongoing medical treatment.

What is the difference between statutory and professional duty of candour?

The statutory duty of candour is a legal requirement for healthcare organisations monitored by the Care Quality Commission under Regulation 20. The professional duty is an ethical obligation for individual doctors and nurses enforced by regulators like the General Medical Council.

What does the County Durham NHS lookback review mean for patients?

The lookback review is examining previous breast care to identify patients whose treatment may need further review. The Trust says it will contact patients directly where necessary, although anyone concerned about previous breast care can also contact its dedicated support team rather than waiting to be contacted.